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Ji Hyun Kim, SeungSoo Rho, Na Rae Kim, Sa Min Hong, Eun Suk Lee, Gong Je Seong, Chan Yun Kim; Vision-determining Structure In Open Angle Glaucoma Patient Using Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2011;52(14):164.
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To determine the structure most significantly correlated with visual acuity in open-angle glaucoma (OAG) using Spectral Domain Optical Coherence Tomography (SD-OCT).
One hundred seventy-eight eyes of 178 patients with OAG were consecutively enrolled from January 2010 to June 2010. Participants underwent RTVue OCT (ONH scan and GCC scan, Optovue Inc, Fremont, CA), and the best corrected visual acuity (BCVA) was obtained during the same visit. The relationship between BCVA and OCT parameters was evaluated using Spearman’s correlation test and regression analysis. Multivariate regression analysis was performed using the BCVA value as a dependent variable. After defining eyes with a BCVA <0.7 as the group having decreased BCVA, a logistic regression analysis was performed with the areas under the receiver operating characteristic (AUROC) curve for variable OCT parameters.
Although the correlation between BCVA and RNFL parameters was limited in the early to moderate glaucoma group, most RNFL parameters were significantly correlated with BCVA in the severe glaucoma group. Of all RNFL parameters, the coefficient of correlation was the highest for the lower temporal (TL) sector, followed by upper temporal (TU) sector, corresponding to the papillomacular bundle area in the severe glaucoma group. Multivariate analysis revealed that papillomacular bundle RNFL thickness and cup to disc area ratio was significantly associated with visual acuity. Logistic regression analysis showed that AUROC of the average RNFL was 0.931 (95% CI: 0.887-0.975), and that of average GCC was 0.875 (95% CI: 0.779-0.972).
Multiple SD-OCT parameters were significantly correlated with visual acuity in glaucoma patients, and such correlations were stronger in patients with more advanced disease. Analysis of the different regions of RNFL thickness showed that RNFL thickness corresponding to the papillomacular bundle area had the highest correlation to the visual acuity.
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