Purchase this article with an account.
Jason L Chien, Mark P Ghassibi, Thipnapa Patthanathamrongkasem, Ramiz Abumasmah, Michael Seth Rosman, Alon Skaat, Celso Tello, Jeffrey M Liebmann, Robert Ritch, Sung Chul (Sean) Park; Glaucoma Diagnostic Capability of Macular Layer Volume and Thickness using Spectral-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4529.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare the diagnostic capability of different macular layer volume and thickness parameters for glaucoma in different-sized grids.
Serial horizontal spectral-domain optical coherence tomography (OCT) scans of the macula (30x25 degree rectangle; interval between scans, ~120 µm) were obtained using Spectralis OCT (Heidelberg Engineering, GmbH, Dossenheim, Germany) in one eye of normal and glaucoma subjects. Automated grids centered on the fovea with diameters of 3, 3.45, and 6 mm were used (Fig 1). For each grid, 10 parameters (total volume of the entire grid and average thicknesses in 9 regions; Fig 1) were obtained for 5 layers: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), ganglion cell-inner plexiform layer (GCIPL; GCL + IPL), and ganglion cell complex (GCC; RNFL + GCL + IPL). The areas under the receiver operating characteristic curve (AUCs) were compared among different parameters and grids.
59 normal eyes (59 subjects) and 59 glaucomatous eyes (59 patients; visual field mean deviation, -7.04±6.98 dB) were included. Mean age was 54±18 and 60±16 years, respectively (p = 0.10). Among 10 parameters for all grid diameters, average thickness at the T2 region had the greatest AUC for GCL, GCIPL, GCC, and IPL (except GCC and IPL for the 6-mm grid), and average thickness at the I2 region had the greatest AUC for RNFL (Table 1). Among 10 parameters for the 6-mm grid, average thicknesses at the I2 and T1 regions had the greatest AUCs for GCC and IPL, respectively. For all 5 layers, the greatest AUC in the 6-mm grid was larger than the greatest AUCs in the 3- and 3.45-mm grids (all p < 0.03 for RNFL and GCC; all p >0.07 for GCL, GCIPL and IPL). Total IPL volume and average IPL thicknesses at the inferior and temporal regions (I2, I1, T2 and T1) had good diagnostic capabilities for all grid diameters (AUC, 0.799-0.872).
Macular layers in each grid are characterized by a specific region with the greatest AUC. Glaucomatous changes occur preferentially in the inferior and temporal macular regions. Larger grids are generally better at detecting glaucoma using macular layer parameters. Macular IPL parameters appear to decrease in glaucoma and may be useful in the diagnosis and monitoring of the disease. Grids that respect horizontal raphe need to be developed and tested for detecting glaucoma.
This PDF is available to Subscribers Only