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jin young Lee, Jung Hwa Na, Kyung Rim Sung; Progression of Retinal Nerve Fiber Layer in glaucoma assessed by Cirrus Optical Coherence Tomography-Guided Progression Analysis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):216.
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To evaluate the capacity of Cirrus spectral domain optical coherence tomography (SD-OCT)-guided progression analysis (GPA) software to detect progression of retinal nerve fiber layer (RNFL) thinning in glaucoma patients.
One-hundred-and-seventy-four eyes of 100 glaucoma patients were included. Each patient was followed-up every 6 months for an average of 2.53 years, during which time data from at least four good-quality Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA) examinations were collected. Stereoscopic optic disc evaluation, RNFL photography, and visual field (VF) testing were performed at the same times. Glaucoma progression was analyzed using the GPA software of the Cirrus OCT, expert assessment of disc and RNFL photographs, VF GPA data, and visual field index (VFI) linear regression analysis. Sensitivity and specificity of Cirrus OCT GPA, and agreement between Cirrus OCT GPA findings and expert assessment of disc and RNFL photographs, and VF progression.
Thirty-one eyes (18.0%) showed progression by expert assessment of stereoscopic optic disc and RNFL photographs, while Cirrus OCT GPA detected progression in 22 eyes (12.6%). When expert assessment of optic disc and RNFL photographs was used as the reference standard, the sensitivity and specificity of the Cirrus OCT GPA employed to detect glaucoma progression were 22.6% and 89.5%. Agreement between Cirrus OCT GPA and disc photographic evaluation was poor (Kappa = 0.127). The agreement between Cirrus OCT GPA results and progression as analyzed by VF evaluation was also poor.
The Cirrus OCT GPA software detected a considerable number of eyes exhibiting glaucoma progression. However, poor agreement was observed between Cirrus OCT GPA findings, on the one hand, and disc and RNFL photography and VF assessment, on the other. Cirrus OCT GPA evaluation may serve to complement disc and RNFL photography and VF examination.
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