April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Glaucoma Discrimination of Segmented Cirrus Spectral Domain Optical Coherence Tomography (SD-OCT) Macular Scans
Author Affiliations & Notes
  • Jacek Kotowski
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • Lindsey S. Folio
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Gadi Wollstein
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • Larry Kagemann
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Hiroshi Ishikawa
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Yun Ling
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Richard A. Bilonick
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
  • James G. Fujimoto
    Department of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts
  • Joel S. Schuman
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
    Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Footnotes
    Commercial Relationships  Jacek Kotowski, None; Lindsey S. Folio, None; Gadi Wollstein, Bioptigen, Inc. (P), Optovue (F); Larry Kagemann, None; Hiroshi Ishikawa, Bioptigen, Inc. (P); Yun Ling, None; Richard A. Bilonick, None; James G. Fujimoto, Carl Zeiss Meditec. Inc (P), Optovue (I); Joel S. Schuman, Bioptigen, Inc (P), Carl Zeiss Meditec, Inc. (P)
  • Footnotes
    Support  NIH R01-EY013178, P30-EY008098, NIH R01-EY013516, NIH R01-EY011289; Eye and Ear Foundation (Pittsburgh, PA); Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 182. doi:
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      Jacek Kotowski, Lindsey S. Folio, Gadi Wollstein, Larry Kagemann, Hiroshi Ishikawa, Yun Ling, Richard A. Bilonick, James G. Fujimoto, Joel S. Schuman; Glaucoma Discrimination of Segmented Cirrus Spectral Domain Optical Coherence Tomography (SD-OCT) Macular Scans. Invest. Ophthalmol. Vis. Sci. 2011;52(14):182.

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Abstract

Purpose: : To evaluate the glaucoma diagnostic ability of Cirrus SD-OCT macular segmentation.

Methods: : 163 subjects (51 healthy, 49 glaucoma suspects and 63 glaucomatous eyes) were imaged with SD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA; Macular and ONH cube protocols). Macular scans were segmented using the manufacturer’s pre-release software into nerve fiber layer (NFL), ganglion cell + inner plexiform layers (inner retinal complex - IRC), outer retinal complex (ORC) and total retina (TR). Age adjusted areas under the receiver operator characteristic curves (AUC) were calculated for overall and sectoral macular layer thickness and circumpapillary retinal NFL (cpRNFL). Glaucoma and glaucoma suspect eyes were grouped together as non-healthy.

Results: : The median visual field mean deviation (MD) for healthy and non-healthy eyes was -0.18 (interquartile range - IQR: -3.14 to 0.78) and -0. 95dB (IQR: -0.92 to 0.71), respectively (p<0.001, Wilcoxon test). IRC+NFL had the highest AUC among global macular layers (0.816, 95% CI: 0.748-0.884) followed by IRC (0.808; 0.737-0.879), TR (0.774; 0.697-0.851), NFL (0.766; 0.689-0.843), ORC (0.709; 0.617-0.800). Inferior IRC had the highest AUC (0.827; 0.759-0.894) among the sectoral macular parameters. AUC of cpRNFL was 0.818 (95% CI: 0.753-0.883). No statistically significant difference was detected between the AUCs of global macular parameters and cpRNFL, except for ORC.

Conclusions: : Cirrus SD-OCT inner retinal macular thickness measurements showed glaucoma diagnostic ability similar to cpRNFL. Macular thickness measurements may be a complementary or an alternative measurement to RNFL thickness assessment in the clinical evaluation of glaucoma.

Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea 
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