April 2010
Volume 51, Issue 13
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ARVO Annual Meeting Abstract  |   April 2010
Effect of Disease Severity on the Diagnostic Accuracy of RTVue Spectral Domain OCT
H. L. Rao; L. M. Zangwill; R. N. Weinreb; P. A. Sample; M. T. Leite; L. M. Alencar; F. A. Medeiros
Author Affiliations & Notes
  • H. L. Rao
    Hamilton Glaucoma Center, UCSD, San Diego, California
    VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India
  • L. M. Zangwill
    Hamilton Glaucoma Center, UCSD, San Diego, California
  • R. N. Weinreb
    Hamilton Glaucoma Center, UCSD, San Diego, California
  • P. A. Sample
    Hamilton Glaucoma Center, UCSD, San Diego, California
  • M. T. Leite
    Hamilton Glaucoma Center, UCSD, San Diego, California
    Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
  • L. M. Alencar
    Hamilton Glaucoma Center, UCSD, San Diego, California
    Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
  • F. A. Medeiros
    Hamilton Glaucoma Center, UCSD, San Diego, California
    Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
  • Footnotes
    Commercial Relationships  H.L. Rao, None; L.M. Zangwill, Optovue, Inc., F; Carl Zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Topcon Medical Systems, Inc., F; R.N. Weinreb, Carl Zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; Alcon Laboratories, Inc., C; Allergan, Inc. (C), C; Carl Zeiss Meditec, Inc., C; Glaxo, C; Optovue, Inc., C; Pfizer, Inc., C; Topcon Medical Systems, Inc., C; P.A. Sample, Carl Zeiss Meditec, Inc., F; Haag-Streit, F; Welch-Allyn, F; M.T. Leite, None; L.M. Alencar, None; F.A. Medeiros, Carl Zeiss Meditec, Inc., F; Pfizer, Inc., F; Alcon Laboratories, Inc., C; Pfizer, Inc., C; Alcon Laboratories, Inc., F; Allergan, Inc. (C,R), C; Alcon Laboratories, Inc., R; Allergan, Inc., R; Carl Zeiss Meditec, Inc., R; Pfizer, Inc., R; Reicherts, Inc., R.
  • Footnotes
    Support  Supported in part by NEI R01-EY08208 (PAS), NEI R01 11008 (LMZ), participant retention incentive grants in the form of glaucoma medication at no cost (Alcon Laboratories Inc., Allergan
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 2978. doi:
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      H. L. Rao, L. M. Zangwill, R. N. Weinreb, P. A. Sample, M. T. Leite, L. M. Alencar, F. A. Medeiros; Effect of Disease Severity on the Diagnostic Accuracy of RTVue Spectral Domain OCT. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2978.

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Abstract
 
Purpose:
 

To evaluate the influence of disease severity on the diagnostic accuracies of optic nerve head (ONH), retinal nerve fiber layer (RNFL) and macular parameters with RTVue (Optovue Inc, Fremont, CA) spectral domain optical coherence tomography (SDOCT) in glaucoma.

 
Methods:
 

In a cross-sectional, observational study, 74 eyes of 44 normal subjects and 140 eyes of 106 glaucoma patients from the Diagnostic Innovations in Glaucoma Study underwent ONH, RNFL and macular imaging with RTVue SDOCT. Glaucoma patients had repeatable abnormal standard automated perimetry (SAP) results (pattern standard deviation abnormal with p>5% and/or abnormal glaucoma hemifield test). Severity of glaucoma was based on Visual Field Index (VFI) values from SAP. Influence of disease severity on the diagnostic accuracy of RTVue was evaluated by receiver operating characteristic (ROC) regression models.

 
Results:
 

Disease severity had a signficant effect on the diagnostic performances of all three scanning areas of RTVue. Lower VFI values were signficiantly associated with larger areas under ROC curve (AUC; P<0.05 for all analysis). For a VFI value of 99, indicating early damage, AUC for rim area, average RNFL thickness and ganglion cell complex-root mean square (GCC RMS) were 0.766, 0.916 and 0.760, respectively. For a VFI of 70, indicating severe damage, corresponding AUC were 0.818, 0.972 and 0.996, respectively. Sensitivities at fixed specificity of 95% showed that average RNFL thickness had a better sensitivity to detect glaucoma in early stages whereas GCC RMS had a better sensitivity in later stages (Figure).

 
Conclusions:
 

Diagnostic accuracy of the RTVue scanning protocols for glaucoma is significantly influenced at different degrees by disease severity. RNFL measurements are more sensitive to detect glaucoma in early stages, whereas macular measurements seem to be more sensitive in later stages.  

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Keywords: imaging/image analysis: clinical • optic disc • nerve fiber layer 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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