Abstract
Purpose :
Glaucoma diagnosis is still based on ophthalmic examination and visual field interpretation. Several structural parameters from the optic nerve and the macular area measured by optical coherence tomography (OCT), and the combination of some of them, have shown noteworthy diagnostic performance. We aimed to validate the discriminative ability of two OCT-based diagnostic calculators (RETICs) and to compare it with that of isolated OCT parameters
Methods :
We revised the charts of 76 primary open-angle glaucoma (A), 107 glaucoma suspects (B), and 67 healthy control cases (C). Demographics, visual field, and high-quality OCT disc and macular parameters were included. The reference diagnosis (clinical examination) was compared against the probability of having glaucoma obtained from the two RETICs glaucoma diagnosis calculators (GDC). Both GDC1 and 2 derived from multivariate logistic regressions using either only the numeric (quantitative) data from peripapillary retinal nerve fiber layer (pRNFL), optic disc, and ganglion cell-inner plexiform layer (GCIPL) (GDC2) or along with qualitative data (color scoring of the quantitative data according to a normative database) (GDC1). The sensitivity and specificity of all parameters were analyzed. The Area Under the Receiver Operating Characteristic Curves (AUROCC) were compared in glaucoma suspects and glaucoma patients, for both calculators, and the best OCT parameters
Results :
The three best OCT parameters in terms of AUROCC for both A and B were inferior pRNFL (0.931; 0.760), average pRNFL (0.925; 0.745), and minimum GCIPL (0.919; 0.735), showing no statistically significant differences among them. The AUROCC from both GDC1 and 2 were high (0.949 & 0.943, p=0.61) and moderate (0.739 & 0.73, p=0.56) for glaucomatous eyes and glaucoma suspects, respectively; compared to the OCT-derived parameters, the discriminative ability was modestly superior and non-inferior for both calculators in A and B groups, respectively. GDC2 was able to correctly classify 46.9% and 14.7% more cases compared to GDC1
Conclusions :
The combination of OCT parameters provided by the RETICs calculators had the highest diagnostic ability to discriminate glaucoma vs control eyes, although it was not as good in glaucoma suspects. GDC2 had the best results, suggesting that adding qualitative structural information does not improve glaucoma diagnosis performance
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.