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Optic nerve head sector analysis recognizes glaucoma most effectively around disc poles.

K G Gundersen¹, A Heijl, B Bengtsson

¹Department of Ophthalmology, Malmö University Hospital, Sweden. kg.gundersen@oftal.mas.lu.se

Acta Ophthalmologica Scandinavica

|March 10, 1999

Summary

Analyzing optic disc topography aids glaucoma detection. Combining superior and inferior pole measurements significantly improves discrimination between normal and glaucomatous eyes, outperforming global assessments.

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Area of Science:

Ophthalmology
Medical Imaging
Glaucoma Research

Background:

Glaucoma diagnosis relies on detecting optic nerve head damage.
Accurate discrimination between normal and glaucomatous optic discs is crucial for timely intervention.
Current methods may not fully capture localized topographical changes.

Purpose of the Study:

To analyze optic disc topography in normal and glaucomatous eyes.
To develop improved strategies for discriminating between normal and glaucomatous eyes.
To evaluate the efficacy of localized sector analysis versus global measurements.

Main Methods:

Raster tomography was used to analyze 225 healthy and 296 glaucomatous eyes.
Measurements included cup area, average cup radius, rim area, and minimal rim width in 24 sectors.

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Receiver Operating Curves (ROC) were calculated for various parameter, sector, and depth combinations.

Main Results:

Discrimination varied by sector, being best at vertical poles and worst in temporal sectors.
Combining superior and inferior pole sectors improved discrimination (sensitivity gain > specificity loss).
Inclusion of temporal sectors significantly reduced separation accuracy; depth had minimal impact.

Conclusions:

Single sectors near the vertical meridian offer better discrimination than global measurements.
Combining superior and inferior pole sectors further enhances diagnostic discrimination.
Localized, asymmetric changes at disc poles are common; cup depth is not critical for separation.