Diagnostic accuracy of OCT with a normative database to detect diffuse retinal nerve fiber layer atrophy: Diffuse...

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Glaucoma is a leading cause of irreversible blindness.
• Early detection of retinal nerve fiber layer (RNFL) atrophy is crucial for timely intervention.
• Optical coherence tomography (OCT) is a key imaging modality for assessing the RNFL.

Purpose of the Study:

• To evaluate the diagnostic accuracy of Stratus OCT using its normative database for detecting diffuse RNFL atrophy in glaucoma patients.
• To compare OCT diagnostic performance with visual field results and RNFL photograph grading.

Main Methods:

• A study enrolled 102 glaucoma patients with diffuse RNFL atrophy and 102 healthy controls.
• Stratus OCT imaging was performed on all participants.
• RNFL photographs were graded by two experienced observers using a four-level system.

Main Results:

• Stratus OCT showed overall sensitivity ranging from 61.5% to 84.5% and specificity from 90.2% to 99.0%.
• Sensitivity for detecting diffuse RNFL atrophy increased with atrophy severity, reaching 100% for severe cases.
• Specific sectors, such as 11-12 o'clock superiorly and 6-7 o'clock inferiorly, showed higher likelihood ratios.

Conclusions:

• OCT with a normative database effectively detects diffuse RNFL atrophy, offering moderate sensitivity and high specificity.
• The diagnostic performance of Stratus OCT is influenced by the degree of RNFL atrophy and visual field status.
• Caution is advised when interpreting OCT results in early glaucoma with diffuse RNFL atrophy.