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Glaucoma Diagnostic Capability of Circumpapillary Retinal Nerve Fiber Layer Thickness in Circle Scans With Different
Mark P Ghassibi1, Jason L Chien, Thipnapa Patthanathamrongkasem
1*Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai§Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital¶Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Medical Center, Harkness Eye Institute, New York∥Department of Ophthalmology, Hofstra Northwell School of Medicine, Hempstead, NY†George Washington University School of Medicine and Health Sciences, Washington, DC‡Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Purpose:
To compare varying circumpapillary optical coherence tomographic (OCT) scan diameters for glaucoma diagnosis.
Materials And Methods:
Prospective, cross-sectional, observational study. Circumpapillary retinal nerve fiber layer thickness (RNFLT) was measured using spectral-domain OCT in 1 randomly selected eye. Scans with diameters of 3.5, 4.1, and 4.7 mm were obtained, each with 7 parameters: mean global (G) RNFLT and mean RNFLT for the temporal-inferior (TI), nasal-inferior (NI), temporal-superior (TS), nasal-superior (NS), nasal (N), and temporal (T) sectors. Areas under the receiver operating characteristic curve (AUCs) were calculated.
Results:
Mean age was 55±18 years in 68 healthy eyes and 59±15 years in 95 glaucomatous eyes (P=0.12). Visual field mean deviation was -7.55±6.61 dB in glaucomatous eyes. In all 3 circle scans, mean TI RNFLT had the greatest AUC (0.974 to 0.983), followed by mean G RNFLT (0.949 to 0.956). The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean TI RNFLTs in the 4.7- (0.978; P=0.128) and 3.5-mm (0.974; P=0.049) scans. The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean G RNFLTs in the 3.5- (0.954; P=0.011), 4.1- (0.956; P=0.016), and 4.7-mm (0.949; P=0.011) scans. In 2 eyes with large parapapillary atrophy, RNFL segmentation error was noted only in the 3.5-mm scan in the area of parapapillary atrophy.
Conclusions:
Further investigations to find the spectral-domain OCT circle scan diameter with the best diagnostic capability and the least artifacts are warranted, especially focusing on larger-than-conventional circle scans.
