Diagnostic ability of Spectral Domain Optical Coherence Tomography to Detect Diffuse Retinal Nerve Fiber Layer Atrophy: Diffuse Atrophy Imaging Study

Abstract

Purpose: To investigate the diagnostic capability of spectral domain (Cirrus) optical coherence tomography (OCT) to detect diffuse retinal nerve fiber layer (RNFL) atrophy.

Methods: This study included 101 eyes from 101 glaucoma patients with diffuse RNFL atrophy and 101 eyes from 101 age-matched healthy individuals. Two experienced glaucoma specialists graded red-free RNFL photographs in eyes with diffuse RNFL atrophy using a 4-level grading system. The area under the receiver operating characteristic curves (AROCs) was compared between normal eyes and eyes with diffuse atrophy. Based on the internal normative database, the sensitivity and specificity of Cirrus OCT were evaluated.

Results: The largest AROCs for Cirrus OCT was obtained with the average RNFL thickness, which was 0.94. Comparison of AROCs in groups with different RNFL atrophy grades revealed that the Cirrus OCT also has a good discriminating ability. Using an internal normative database with abnormality defined at a <5% level, the overall sensitivity of Cirrus OCT to detect diffuse RNFL atrophy ranged from 75.0% to 87.0%. According to the internal normative database at a <5% level, the highest sensitivity was 87.0% for Cirrus OCT and it was obtained with the TSNIT thickness graph and the deviation map.

Conclusions: The AROCs and the sensitivity obtained from Cirrus OCT showed that it has a good diagnostic ability to detect diffuse RNFL atrophy.

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 610 nerve fiber layer