Abstract
Purpose :
To evaluate the diagnostic accuracy of a solely optical coherence tomography (OCT)-based glaucoma risk score, Fukai Nakano score, for glaucoma detection in eyes with myopia, and to compare with single OCT measurement parameter, including thickness of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell–inner plexiform layer (GCIPL).
Methods :
Cross-sectional data were collected from myopic eyes with or without glaucoma. Because a change in refractive error can occur after refractive or cataract surgery, myopic eyes were defined as eyes with axial length (AL) > 24.0 mm, and myopic eyes in each group were further divided into mild myopia subgroup (24.0mm < AL ≤ 26.0 mm) and high myopia subgroup (AL > 26.0 mm). All eyes were scanned by 3D OCT-1 Maestro (SD-OCT). The macular and peripapillary inner retinal layer thickness measurements was obtained from the Wide scan (12mm x 9mm). The segments and grids were restructured, and variables were employed in 4 models 1, 2, 3A, and 3B to generate Fukai Nakano scores for each eye. Areas under the receiver operating characteristic curves (AUROCs), sensitivity, and specificity were used to evaluate differentiation performance of Fukai Nakano scores. AUROCs were adjusted for inclusion of both eyes and for age, image quality, disc size, and AL as possible confounders.
Results :
A total of 147 eyes (93 healthy myopic eyes and 54 myopic eyes with glaucoma) were included, in which 124 eyes with mild myopia and 23 eyes with high myopia. The mean AL [95% confidence limits (CL)] was 25.04 (24.88, 25.21) mm for the healthy group and 25.19 (24.99, 25.39) mm for the glaucoma group. When differentiate healthy myopic eyes and myopic eyes with glaucoma, all 4 Fukai Nakano scores showed AUROCs≥ 0.90 which were superior to GCIPL 0.83 (0.72, 0.91) and cpRNFL 0.88 (0.76, 0.94). Similarly, comparing with cpRNFL and GCIPL, Fukai Nakano scores had higher AUROCs in mild myopia subgroup (≥0.91) and high myopia subgroup (≥0.86). Moreover, Fukai Nakano scores had superior or similar sensitivity at 90% specificity in all groups, except model 3A in high myopia subgroup.
Conclusions :
Fukai Nakano scores generated from OCT Wide scan outperformed single OCT thickness parameters for screening glaucoma in myopic eyes, indicating promise of the OCT-based glaucoma risk score for aiding eye care providers’ decision making, particularly in an optometry setting.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.