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Jung Hwa Na, Youngrok Lee, Kyung Rim Sung, Michael S. Kook; Glaucoma Detection Capability of Optic Disc, Peripapillary Retinal Nerve Fiber Layer, and Macular Thickness with RTVue Spectral-Domain Optical Coherence Tomography in Preperimetric Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):194.
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To evaluate the capability of the optic nerve, peripapillary retinal nerve fiber layer (p-RNFL), and macular (GCC) parameters in discriminating healthy eyes from those with preperimetric glaucoma using spectral domain optical coherence tomography (SD-OCT, RTVue 100, software version 5.0; Optovue, Inc.).
Ninety three eyes from 93 subjects (42 eyes with preperimetric glaucoma and 51 age and refractive error-matched healthy eyes) were recruited prospectively, in a consecutive manner from July 2010 to October 2010. The red-free photography was evaluated by two glaucoma specialists, and only those eyes that had RNFL defect (localized and/or diffuse) agreed by both specialists were enrolled as glaucomatous eyes. Areas under the receiver operating curves (AUCs) and sensitivities at fixed specificities (80%, 90%, and 95%) were calculated and compared among various site-specific parameters.
Average RNFL thickness for the p-RNFL parameters showed the best diagnostic capability (AUC 0.848, p<0.0001). However, there was no statistically significant difference between Average RNFL thickness and Superior GCC thickness for macular parameters (AUC: 0.848 vs. 0.812, p=0.6063). Horizontal C/D ratio showed the largest AUC (AUC 0.787, p= 0.0008) among optic disc parameters. Average RNFL thickness showed the highest sensitivities among all parameters at specified specificities (67%, 58%, and 58%, respectively).
Macular thickness parameters (Average, Superior, and Inferior GCC) had similar detection capabilities compared to p-RNFL parameters. Based on RTVue OCT, optic disc parameters were not as sensitive as p-RNFL or GCC parameters in differentiating preperimetric glaucoma from healthy eyes. Macular parameters may be a good adjunctive to p-RNFL thickness in the assessment of preperimetric glaucoma.
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