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Enhanced Diagnostic Capability for Glaucoma of 3-Dimensional Versus 2-Dimensional Neuroretinal Rim Parameters Using
Kenneth C Fan1, Edem Tsikata, Ziad Khoueir
1*Boston University School of Medicine, Boston Medical Center †Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Glaucoma Service ‡Harvard Medical School, Boston, MA §Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon ∥Department of Ophthalmology, Pamukkale University, Denizli, Turkey ¶The Johns Hopkins University School of Medicine, Baltimore, MD #University of the East Ramon Magsaysay Memorial Medical Center, Quezon City **Romblon Provincial Hospital, Romblon, Philippines ††Department of Physics and Astronomy, LaserLaB Amsterdam, VU University ‡‡Department of Ophthalmology, VU Medical Center, Amsterdam, The Netherlands.
Purpose:
To compare the diagnostic capability of 3-dimensional (3D) neuroretinal rim parameters with existing 2-dimensional (2D) neuroretinal and retinal nerve fiber layer (RNFL) thickness rim parameters using spectral domain optical coherence tomography (SD-OCT) volume scans.
Materials And Methods:
Design: Institutional prospective pilot study.
Study Population:
65 subjects (35 open-angle glaucoma patients, 30 normal patients).
Observation Procedures:
One eye of each subject was included. SD-OCT was used to obtain 2D RNFL thickness values and 5 neuroretinal rim parameters [ie, 3D minimum distance band (MDB) thickness, 3D Bruch's membrane opening-minimum rim width (BMO-MRW), 3D rim volume, 2D rim area, and 2D rim thickness].
Main Outcome Measures:
Area under the receiver operating characteristic curve values, sensitivity, and specificity.
Results:
Comparing all 3D with all 2D parameters, 3D rim parameters (MDB, BMO-MRW, rim volume) generally had higher area under the receiver operating characteristic curve values (range, 0.770 to 0.946) compared with 2D parameters (RNFL thickness, rim area, rim thickness; range, 0.678 to 0.911). For global region analyses, all 3D rim parameters (BMO-MRW, rim volume, MDB) were equal to or better than 2D parameters (RNFL thickness, rim area, rim thickness; P-values from 0.023 to 1.0). Among the three 3D rim parameters (MDB, BMO-MRW, and rim volume), there were no significant differences in diagnostic capability (false discovery rate >0.05 at 95% specificity).
Conclusions:
3D neuroretinal rim parameters (MDB, BMO-MRW, and rim volume) demonstrated better diagnostic capability for primary and secondary open-angle glaucomas compared with 2D neuroretinal parameters (rim area, rim thickness). Compared with 2D RNFL thickness, 3D neuroretinal rim parameters have the same or better diagnostic capability.
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