Discrimination Between Glaucomatous and Non–Glaucomatous Eyes of Black and White Subjects Using Quantitative Optic Disc Topography (OCT III And HRT II), Retinal Nerve Fiber Layer Analysis (OCT III and Gdx–Vcc), and Subjective Optic Disc Assessment

Abstract

 

Abstract:

 

To compare the ability of quantitative analysis of optic disc topography, retinal nerve fiber layer thickness, and subjective assessment of the optic nerve head to detect glaucoma in Blacks and Whites. Data from one eye of 65 glaucoma patients and 162 normal subjects were used in the analysis. Glaucoma was defined based on repeatable visual field defects. 137 subjects were Black, 90 were White. All subjects underwent imaging with the most recent versions of confocal scanning laser ophthalmoscopy (HRT II), optical coherence tomography (OCT III), scanning laser polarimetry (GDx–VCC), and simultaneous stereophotography. The photographs were graded independently in a masked fashion by three graders with glaucoma subspecialty training on a 5–point scale. An overall photo score was developed by the summation of the 3 independent grades. OCT imaging included peripapillary scans of retinal nerve fiber layer thickness (OCT RNFL), and optic disc topography (OCT Disc). For each global and regional scan parameter and for the overall stereophoto score, an age–adjusted area under the receiver operator curve (aROC) was calculated. The parameter with the highest aROC for each method was statistically compared between techniques and subjectively compared between racial groups. There were no significant differences between the best performing parameters between each of the imaging methods and subjective evaluation of photographs (p > 0.05). The aROC values for each technique were lower in Black subjects as compared to White subjects for all techniques.

 

 

^{Retinal nerve fiber layer analysis (GDx–VCC and OCT III) and optic disc topography (HRT II and OCT III) performed as well as expert assessment in the detection of glaucoma. The detection of glaucoma was more difficult in Black subjects with all methods.}

 

 

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)