Comparison of Laser Scanning Diagnostic Devices for Early Glaucoma Detection

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Diagnostics

Background:

• Early glaucoma detection is crucial for preventing vision loss.
• Optic nerve head and retinal nerve fiber layer (RNFL) thickness are key indicators.
• Comparing advanced imaging technologies aids in selecting optimal diagnostic tools.

Purpose of the Study:

• To compare the diagnostic accuracy of FD-OCT, CSLO, and SLP for early glaucoma detection.
• To evaluate the correlation of optic nerve head and RNFL thickness measurements between these modalities.
• To assess the utility of these technologies in differentiating glaucoma from healthy eyes.

Main Methods:

• Observational, cross-sectional study including 93 early open-angle glaucoma patients, 58 ocular hypertension patients, and 60 healthy controls.
• Imaging of optic nerve head and RNFL using FD-OCT, CSLO, and SLP.
• Analysis of diagnostic accuracy using Area Under the Receiver Operating Characteristic Curves (AUROC) and Bland-Altman analysis.

Main Results:

• FD-OCT cup-to-disc ratio (AUROC=0.841) and SLP Nerve Fiber Index (NFI) (AUROC=0.835) demonstrated the highest diagnostic accuracy.
• CSLO cup-to-disc ratio achieved an AUROC of 0.789.
• Diagnostic accuracy of CSLO and SLP were similar (P=0.259), while FD-OCT showed a marginally significant difference compared to CSLO (P=0.047).

Conclusions:

• FD-OCT and SLP offer similarly high diagnostic ability for distinguishing early glaucoma from healthy subjects.
• CSLO's diagnostic accuracy is comparable to SLP and slightly lower than FD-OCT.
• These findings support the use of FD-OCT and SLP as valuable tools in early glaucoma diagnosis.