April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Value of Optical Coherence Tomography for Glaucoma Detection in a Population-Based Setting
Author Affiliations & Notes
  • Henriet Springelkamp
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Kyungmoo Lee
    Electrical and Computer Engineering, University of Iowa, Iowa City, IA
  • Roger C Wolfs
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Gabrielle HS Buitendijk
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Wishal D Ramdas
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Johannes R Vingerling
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Caroline C W Klaver
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Michael David Abramoff
    Ophthalmology & Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, IA
    Biomedical Engineering, University of Iowa, Iowa City, IA
  • Nomdo M Jansonius
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, University of Groningen, University Medical Center, Groningen, Netherlands
  • Footnotes
    Commercial Relationships Henriet Springelkamp, None; Kyungmoo Lee, None; Roger Wolfs, None; Gabrielle Buitendijk, None; Wishal Ramdas, None; Johannes Vingerling, None; Caroline Klaver, Topcon (F); Michael Abramoff, IDx, LLC (E), IDx, LLC (I), University of Iowa (P); Nomdo Jansonius, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4740. doi:
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      Henriet Springelkamp, Kyungmoo Lee, Roger C Wolfs, Gabrielle HS Buitendijk, Wishal D Ramdas, Johannes R Vingerling, Caroline C W Klaver, Michael David Abramoff, Nomdo M Jansonius; The Value of Optical Coherence Tomography for Glaucoma Detection in a Population-Based Setting. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4740.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Optical coherence tomography (OCT) is an accepted diagnostic tool for glaucoma. In addition to thinning of the peripapillary retinal nerve fiber layer (RNFL), thinning of various retinal layers in the macula appears to be important for the assessment of glaucoma as well. We determined the screening performance of thickness measurements of three retinal layers assessed by OCT in a population-based setting.

Methods: We included participants from the population-based Rotterdam Study who had undergone visual field testing (Humphrey Field Analyzer) and OCT scanning of the macula and optic nerve head (Topcon 3D OCT 1000). We automatically determined the mean thicknesses of the RNFL, retinal ganglion cell layer (RGCL), and inner plexiform layer for various regions of interest, thus defining a series of OCT parameters, using the Iowa Reference Algorithms. The visual field tests were classified as abnormal if two suprathreshold tests followed by a 24-2 SITA standard test showed reproducible abnormalities; glaucomatous visual field loss (GVFL) was diagnosed per exclusionem. We defined glaucoma as the presence of GVFL and determined areas under the receiver operating characteristics curves (AUCs) for each OCT parameter. Sensitivity at 97.5% specificity was calculated for a subset of variables with the highest AUCs.

Results: We included 1087 controls and 41 cases. The median (IQR) mean deviation of the HFA visual fields of the cases was -6.5 dB (-3.8 to -10.5 dB). The mean RGCL thickness of the inferior half of the macular scan had the highest AUC (0.85; 95% confidence interval 0.83-0.88). The mean thickness of the peripapillary RNFL had an AUC of 0.77 (0.74-0.79). At 97.5% specificity, the mean RGCL thickness of the inferior half of the macular scan had a sensitivity of 53.7% (37.7-69.6%).

Conclusions: The RGCL thickness of the inferior half of the macular scan can discriminate between glaucoma cases and controls in a population-based setting and has - compared to other OCT parameters and other imaging techniques - a good screening performance.

Keywords: 550 imaging/image analysis: clinical • 531 ganglion cells • 610 nerve fiber layer  
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