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Fabio Lavinsky, Camila Z Benfica, Nedio Castoldi, Jaco Lavinsky, Paulo Augusto A Mello; Measurement of the Hypotenuse of the Optic Disc Cupping with Spectral domain Optic Coherence Tomography Enhanced Depth Imaging compared with Standard Automated Perimetry. Invest. Ophthalmol. Vis. Sci. 2014;55(13):967.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the hypotenuse of the optic disc cupping (HODC) , a parameter that evaluates either the length and the depth of the optic disc cupping, measured by spectral-domain optical coherence tomography (SD-OCT) enhanced depth imaging (EDI), and its functional correlation with the mean deviation (MD) of the standard automated perimetry (SAP).
A transversal study was performed. A hundred and fifty eight eyes of 92 patients had the HODC measured by SD-OCT (Specralistm from Heildelberg Engineeringtm) EDI by only one experienced examiner. The largest vertical cup was screened, and the length of the cupping was measured by a caliper from the end of the neural tissue at the level of RPE line, the depth was measured with a line 90 degrees from the previous one until the deepst point of the lamina cribosa. Those two lines consisted into the legs of the triangle used to calculate the HODC. SAP was performed using HumphreyTM perimetry (Zeisstm), strategy SITA-Standrd 24-2. The analysis of the correlation was performed using the linear mixed models of the Statistical Package for Social Sciences SPSS, Chicago, IL, USA version 2.0.
The analysis was performed dividing the patients in four groups of HODC: group 1 had a mean HODC of 844,47μm, group 2 of 1177,95μm, group 3 of 1401,57μm and group 4 of 1662,41μm. The first group had a mean MD of -4,75dB (Standard Error=1,56); the second of -6,04dB (Standard Error=1,47); the third of -9,66dB (Standard Error=1,40); and the forth of -12,00dB (Standard Error=1,43). There were statistically significant correlations between group 1 and group 4 (p<0.004), between group 2 and 4 (p<0.015), and a borderline correlation between group 1 and group 3 (p<0.082).
The tridimensional measurement of HODC by SD-OCT EDI provides a numeric parameter obtained from two important hallmarks of the glaucomatous nerve: the length of the cupping and the depth of the collapse of the lamina cribosa. This measurement can be used as an additional structural parameter to evaluate glaucoma. In our study, we found a structural-functional correlation of this parameter with the results of SAP.
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