June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Retinal Nerve Fiber Layer Defects on Ultrawide Field Imaging and Spectral-Domain Optical Coherence Tomography: Significance for Glaucoma Detection in Adult Diabetic Patients
Author Affiliations & Notes
  • Brian J Song
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Ambika Hoguet
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Louis R Pasquale
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Paolo Sandico Silva
    Ophthalmology, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Lloyd P Aiello
    Ophthalmology, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Brian Song, None; Ambika Hoguet, None; Louis Pasquale, None; Paolo Silva, Optos (F); Lloyd Aiello, Optos (F), Optos (R)
  • Footnotes
    Support  Harvard Vision Clinical Scientist Development Program NIH 2K12 EY016335-11, Harvard Glaucoma Center of Excellence, Massachusetts Lions Eye Research Fund
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3997. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Brian J Song, Ambika Hoguet, Louis R Pasquale, Paolo Sandico Silva, Lloyd P Aiello; Retinal Nerve Fiber Layer Defects on Ultrawide Field Imaging and Spectral-Domain Optical Coherence Tomography: Significance for Glaucoma Detection in Adult Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3997.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To compare retinal nerve fiber layer (RNFL) defects observed on ultrawide field imaging (UWFI) with spectral-domain optical coherence tomography (OCT) and Humphrey visual field (HVF) findings to determine their significance in adult diabetic patients.

Methods : Monoscopic color and red-free (green channel) UWFI were reviewed independently by two glaucoma specialists (BJS and AH) for the presence (none, localized, diffuse) and location (clock-hour) of RNFL defects. Disparities were adjudicated by consensus. Unweighted kappa was used to calculate agreement of RNFL defects identified on UWFI with an abnormality on the OCT-RNFL sector map. Sensitivity and specificity for detection of RNFL defects on UWFI using OCT as a reference standard was also calculated. A subset of patients with HVF within 6 months of UWFI were reviewed for the presence of a glaucomatous field deficit.

Results : 103 eyes of 54 patients had OCT-RNFL and UWFI within 6 months. Demographic data are summarized in Table 1. RNFL was gradable in 93/103 (90.3%) of UWFI. A RNFL defect was seen in 26/93 (27.9%; 16 localized, 10 diffuse) UWFI scans compared to 40/93 eyes (51.6%; 19 localized, 21 diffuse) that had a RNFL abnormality on the sector map of the OCT-RNFL. 21 of 26 eyes with a defect on UWFI (80.8%) were associated with an OCT-RNFL abnormality (kappa=0.49±0.086), in which the location of the defect observed correlated with the OCT in 15/21 (71.4%; Figure 1). Among the 10 UWFI scans where the RNFL was not gradable, 8 (80%) had a RNFL defect on OCT. Sensitivity and specificity of UWFI for detection of RNFL defects was 52.5% and 90.6%, respectively.

55 eyes from 29 patients had a HVF within 6 months of UWFI. Of these, 46/55 (83.6%) were reliable. 18 of these 46 (39.1%) were abnormal. Of the 5 eyes with a RNFL defect on UWFI and a HVF within 6 months, 3 eyes (60.0%) had an abnormal HVF. Of the 15 eyes with a OCT-RNFL abnormality and a HVF within 6 months, 10 eyes (66.7%) had an abnormal HVF.

Conclusions : RNFL defects seen on UWFI have high specificity for abnormalities on OCT with over 60% being associated with HVF abnormalities. Observation of RNFL defects or inability to grade the RNFL may warrant further evaluation for glaucoma among diabetic patients imaged with UWFI in teleretinal programs where ancillary testing for glaucoma is often unavailable.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×