Using Enhanced Depth Imaging Optical Coherence Tomography-Derived Parameters to Discriminate between Eyes with and...

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• New technologies aim to reduce subjectivity in glaucoma diagnosis.
• Enhanced depth imaging spectral-domain OCT (EDI OCT) is valuable for assessing optic nerve head (ONH) structures.

Purpose of the Study:

• To compare the diagnostic performance of various EDI OCT-derived parameters in differentiating between eyes with and without glaucoma.

Main Methods:

• A prospective cross-sectional study was conducted.
• Measured ONH parameters included lamina cribrosa (LC) thickness and area, prelaminar neural tissue (PLNT) thickness and area, and Bruch's membrane opening - minimum rim width (BMO-MRW).
• Peripapillary retinal nerve fiber layer (pRNFL) thickness was also assessed.

Main Results:

• Average BMO-MRW, PLNT area, and average pRNFL thickness showed high diagnostic performance (AUCs ≈ 0.97-0.99).
• These parameters significantly outperformed LC area (AUC = 0.701).
• At 80% specificity, sensitivities were: PLNT area (92.3%), average BMO-MRW (97.4%), and average pRNFL thickness (94.9%).

Conclusions:

• Neural tissue-based parameters (BMO-MRW, PLNT area) demonstrate superior diagnostic performance over laminar parameters for glaucoma detection.
• PLNT area, evaluated for the first time, showed promising results.
• EDI OCT ONH parameters, particularly neural tissue metrics, offer diagnostic performance comparable to the established pRNFL thickness protocol.