September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Measurement of the Hypotenuse of the Vertical Optic Nerve Head Cupping (HVOC) with Spectral Domain Optic Coherence Tomography: Evaluation of a Potential Novel Parameter for Glaucoma Structural Diagnosis
Author Affiliations & Notes
  • Fabio Lavinsky
    Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Sao Paulo, Sao Paulo, Brazil
    Ophthalmology, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
  • Nedio Castoldi
    Ophthalmology, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
  • Camila Zanella Benfica
    Ophthalmology, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
  • Paulo Augusto de Arruda Mello
    Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Sao Paulo, Sao Paulo, Brazil
  • Footnotes
    Commercial Relationships   Fabio Lavinsky, None; Nedio Castoldi, None; Camila Benfica, None; Paulo Augusto Mello, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 383. doi:
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      Fabio Lavinsky, Nedio Castoldi, Camila Zanella Benfica, Paulo Augusto de Arruda Mello; Measurement of the Hypotenuse of the Vertical Optic Nerve Head Cupping (HVOC) with Spectral Domain Optic Coherence Tomography: Evaluation of a Potential Novel Parameter for Glaucoma Structural Diagnosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):383.

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

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Abstract

Purpose : To evaluate the measurement of the hypotenuse of the vertical optic nerve head cupping (HVOC) with the enhanced depth imaging (EDI) mode of the spectral domain optic coherence tomography (SD-OCT) as a novel structural parameter for glaucoma diagnosis.

Methods : We conducted a prospective, transversal study with patients diagnosed with glaucoma and controls. Patients underwent SD-OCT evaluating the mean retinal nerve fiber layer thickness (RNFL) and the HVOC, which one leg of the triangle represented the depth and the other the length of the cupping. Patients also underwent color pictures and standard automated perimetry (SAP). The evaluation was performed in 156 eyes (83 patients) that were divided in 3 groups: 1-MD<-7DB, 2-MD>-7DB and 3-patients without glaucoma. The evaluation using the receiver operating characteristic (ROC) curve excluded eyes with the vertical diameter of the optic nerve >2.0 and <1.5.

Results : The mean SD-OCT RNFL values were: group 1 (56 eyes): 62.5µm, group 2 (74 eyes) 83.8µm and group 3 (34 eyes) 98.7µm (p<0.0001 and r=-0.66). The means of the MD were: group 1: -16.72 DB, group 2: -2.70 DB and group 3: -1.49 DB( p<0.001 and r=-0.81). The correlation of the SD-OCT RNFL and the SAP was statistically significant (p<0.0001 e r=0.681). The correlation between the HVOC and the MD was Spearman rho= -.465 e Pearson= -.511, and with the RNFL was Spearman rho= -.624, Pearson =-.634 (n=120). The areas under the curve (AUC) of the ROC curve evaluating the HVOC were: for MD< -3DB as positives cases= 0.755 (0.664-0.845), MD < -6DB= 0,77 (0.678-0.862) and MD < -12DB= 0.798 (0.705-0.890). The ROC curves of the RNFL were compared with the HVOC using DeLong test and there was no statistically significant difference. For positive cases determined as MD< -12DB they had a borderline difference (p=0.06).

Conclusions : In our study, we found a structural-functional correlation of the HVOC with the MD of the SAP as well as with the RNFL. The AUC of the ROC curves of HOVC were comparable with those of the RNFL. The HOVC has a potential to be used as an additional optic nerve head parameter of the multimodal structural evaluation of glaucoma.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Scatter plot showing the correlation between the MD of the SAP and the HVOC.

Scatter plot showing the correlation between the MD of the SAP and the HVOC.

 

Scatter plot showing the correlation between the RNFL and the HVOC

Scatter plot showing the correlation between the RNFL and the HVOC

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