June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Reproducibility of Minimum Rim Width and Retinal Nerve Fiber Layer Thickness Measurements using the Anatomic Positioning System in Patients with Glaucoma and Normal Controls
Author Affiliations & Notes
  • Lalita Gupta
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
    George Washington University School of Medicine, Washington, District of Columbia, United States
  • Priyanka Gogte
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Safa Siraj
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Scott S Fudemberg
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Anand V Mantravadi
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Lisa A Hark
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • L Jay Katz
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michael Waisbourd
    Glaucoma Research Department, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Lalita Gupta, None; Priyanka Gogte, None; Safa Siraj, None; Scott Fudemberg, None; Anand Mantravadi, None; Lisa Hark, None; L Jay Katz, None; Michael Waisbourd, None
  • Footnotes
    Support  Wills Eye Innovation Grant WEF15064. Heidelberg Engineering provided the Spectralis Optical Coherence Tomography testing platform used in this study
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1322. doi:
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    • Get Citation

      Lalita Gupta, Priyanka Gogte, Safa Siraj, Scott S Fudemberg, Anand V Mantravadi, Lisa A Hark, L Jay Katz, Michael Waisbourd; Reproducibility of Minimum Rim Width and Retinal Nerve Fiber Layer Thickness Measurements using the Anatomic Positioning System in Patients with Glaucoma and Normal Controls. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1322.

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

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Abstract

Purpose : To perform a prospective, cross-sectional study to determine the test-retest repeatability of minimum rim width (MRW) and retinal nerve fiber layer (RNFL) thickness measurements obtained by spectral-domain optical coherence tomography (SD-OCT) using the anatomic positioning system (APS) protocol in glaucoma patients and controls. In addition, the diagnostic ability of the MRW and RNFL thickness was assessed in three circular peripapillary locations.

Methods : SD-OCT (Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany) scans of the optic nerve head were obtained twice at one visit using the APS protocol. MRW was measured and RNFL thickness measurements were obtained at three peripapillary locations (3.5 mm, 4.1 mm, and 4.7 mm). Intraclass correlation coefficients (ICCs) and areas under the receiver operating characteristic curve (AUCs) were calculated.

Results : A total of 36 glaucomatous eyes and 59 control eyes were included in the analysis. ICCs of MRW and RNFL thickness (3.5 mm and 4.1 mm circles) ranged between 0.98-1.00 for global measurements. The ICCs of global RNFL thickness measurements in the larger diameter circle (4.7 mm) were lower (0.76 - 0.90). The MRW had an AUC of 0.97 while the RNFL thickness measurements were 0.95, 0.95, and 0.96 for the 3.5 mm circle, 4.1 mm circle, and 4.7 mm circle respectively.

Conclusions : MRW and RNFL thickness measurements using the APS protocol had overall excellent reproducibility and diagnostic performance. Therefore, using this protocol and the novel parameter MRW may be useful in diagnosing and evaluating patients with glaucoma.

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

 

Top left: Infrared image of optic nerve head (ONH) with Fovea-to-Bruch’s Membrane Opening (FoBMOC) axis as defined by Anatomic Positioning System (APS). Top right: Infrared image of ONH with 48 Bruch’s membrane opening (BMO) points (dots). Middle: B-scan showing the BMO (red dots), Internal limiting membrane (ILM) (red line), and minimum rim width (MRW) (arrow). Bottom: Sector map showing average BMO-MRW measurements by sector and globally. A diagram of the thickness profile of BMO-MRW (black line).

Top left: Infrared image of optic nerve head (ONH) with Fovea-to-Bruch’s Membrane Opening (FoBMOC) axis as defined by Anatomic Positioning System (APS). Top right: Infrared image of ONH with 48 Bruch’s membrane opening (BMO) points (dots). Middle: B-scan showing the BMO (red dots), Internal limiting membrane (ILM) (red line), and minimum rim width (MRW) (arrow). Bottom: Sector map showing average BMO-MRW measurements by sector and globally. A diagram of the thickness profile of BMO-MRW (black line).

 

Age-adjusted receiver operating characteristic (ROC) curves for the global Minimum Rim Width (MRW), inner circle (3.5mm) Retinal Nerve Fiber Layer (RNFL) thickness, middle circle (4.1mm) RNFL thickness, and outer circle (4.7mm) RNFL thickness.

Age-adjusted receiver operating characteristic (ROC) curves for the global Minimum Rim Width (MRW), inner circle (3.5mm) Retinal Nerve Fiber Layer (RNFL) thickness, middle circle (4.1mm) RNFL thickness, and outer circle (4.7mm) RNFL thickness.

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