Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma

Eye (Lond). 2014 Jun;28(6):654-61. doi: 10.1038/eye.2014.46. Epub 2014 Mar 7.

Abstract

Purpose: To compare the abilities of retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting glaucoma.

Methods: In a cross-sectional study, 215 eyes of 165 subjects (106 eyes of 79 glaucoma patients and 109 eyes of 86 controls) referred by general ophthalmologists for glaucoma evaluation underwent RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT to discriminate glaucoma eyes from control eyes was compared with that of GDx ECC using area under operating characteristic curves (AUCs), sensitivities at fixed specificities, and likelihood ratios (LRs).

Results: AUC of the average RNFL thickness of SDOCT to differentiate glaucoma from control eyes (0.868) was comparable (P=0.32) to that of GDx ECC (0.855). Sensitivity at 95% specificity was 63.2% for average RNFL thickness of SDOCT and 48.1% for the average RNFL measurement of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 5.6 and 7.7 while the same of GDx ECC parameters ranged between 3.1 and 3.7. LRs of within normal limits category of SDOCT parameters ranged between 0.18 and 0.24 while the same of GDx ECC parameters ranged between 0.20 and 0.32.

Conclusion: Though AUCs and sensitivities at fixed specificities were comparable between the RNFL parameters of SDOCT and GDx ECC in diagnosing glaucoma, LRs indicated that the RNFL parameters of SDOCT were better in 'ruling in' glaucoma.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Area Under Curve
  • Cross-Sectional Studies
  • Female
  • Glaucoma / diagnosis*
  • Humans
  • Intraocular Pressure
  • Likelihood Functions
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Retinal Ganglion Cells / pathology*
  • Scanning Laser Polarimetry / methods*
  • Sensitivity and Specificity
  • Tomography, Optical Coherence / methods*
  • Visual Fields