Purchase this article with an account.
Yoon Jeon Kim, Jung Hwa Na, Mary K. Durbin, Kyung Rim Sung; Glaucoma Progression Detection by Segmented Macula Thickness Assessed by Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):213.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate both diagnostic and progression detection capability of segmented macular layer thickness and compare those outcomes with circumpapillary retinal nerve fiber layer (cRNFL) and total macular thickness (TM) by use of spectral domain optical coherence tomography (SD-OCT, Cirrus HD OCT, Carl Zeiss Meditec. Inc) in glaucomatous eyes.
One-hundred-and-forty-one eyes with glaucoma and 61 healthy eyes were included. All glaucomatous eyes had at least four good-quality SD OCT examinations with a mean follow-up of 2.13 years. Macular thickness was segmented into 3 layers; macular NFL, GCA (ganglion cell layer and inner plexiform layer), and outer retinal layer (ORL; from outer plexiform layer to Bruch’s membrane). The areas under the receiver operating characteristic curves (AUC) discriminating healthy from glaucomatous eyes were determined using baseline OCT parameters. The sensitivity and specificity for progression detection when the expert assessment of optic disc/RNFL photographs and/or visual filed (VF) progression used as standard was determined in OCT parameters.
Among segmented macular parameters, GCA showed best performance. AUC of GCA was inferior to that of cRNFL thickness (0.858 vs. 0.935, p=0.018), but superior to TM thickness (0.789, p=0.05). Thirty eight eyes showed progression during follow-up time by experts’ assessment of the optic disc stereophotographs and/or VF. TM and GCA thickness showed better sensitivity than cRNFL thickness (16%, 8%, 5%) in progression detection.
Although baseline cRNFL was better in the diagnosis of glaucoma, GCA and TM thickness showed higher sensitivity and better agreement with standard method than that of cRNFL. We may suggest macular parameters such as GCA and TM measured by OCT can be used as assessment strategy for progression detection in glaucoma.
This PDF is available to Subscribers Only