Comparison of Cup-to-disc Ratio Using the Superfield Lens and Optical Coherence Tomography

Byung Joo Cho

doi:10.3341/jkos.2008.49.4.611

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Cho: Comparison of Cup-to-disc Ratio Using the Superfield Lens and Optical Coherence Tomography

Original Article

J Korean Ophthalmol Soc 2008;49(4):611-616.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.4.611

Comparison of Cup-to-disc Ratio Using the Superfield Lens and Optical Coherence Tomography

Byung Joo Cho, M.D.

Department of Ophthalmology, Konkuk University School of Medicine, Seoul, Korea

Address reprint requests to Byung Joo Cho, M.D. Department of Ophthalmology, Konkuk University Hospital #4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea Tel: 82-2-2030-5270, Fax: 82-2-2030-7748, E-mail: bjcho@kuh.ac.kr

Received 4 January 2007 Accepted 15 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The author compared the effect of the cup-to-disc ratio using the Volk Superfield lens and optical coherence tomography (OCT) to evaluate its usefulness in glaucoma diagnosis and follow-up.

Methods

One hundred ninety-seven eyes of 100 patients were enrolled: 34 normal, 75 glaucoma suspected, 43 normal tension glaucoma (NTG), 45 primary open angle glaucoma (POAG). Routine ophthalmic examinations, fundus examinations, and cup-to-disc ratio measurement using the Superfield lens after pupil dilatation, visual field test, OCT optic nerve head analysis, and OCT retinal nerve fiber layer analysis were performed. The author compared cup-to-disc ratio using the Superfield lens and OCT in normal, glaucoma suspected, normal tension glaucoma, and primary open angle glaucoma.

Results

Using the Superfield lens, the mean cup-to-disc ratio was 0.36±0.07 in normal eyes, 0.61±0.12 in suspected glaucoma, 0.75±0.11 in NTG, 0.70±0.17 in POAG. Using OCT, the mean cup-to-disc ratio was 0.58±0.13 in normal eyes, 0.69±0.12 in suspected glaucoma, 0.80±0.10 in NTG, and 0.76±0.15 in POAG. In all groups, cup-to-disc ratio using OCT were greater than using the Superfield lens and were statistically significant.

Conclusions

Considering these differences in the clinical assessment of glaucoma, the combined use of the Superfield lens and OCT would be helpful in its diagnosis and follow-up.

Keywords: Cup-to-disc ratio, Normal tension glaucoma, Optical coherence tomography, Primary open angle glaucoma, Superfield

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Table 1.

Patient Characteristics (n=197 eyes)

	Normal	Glaucoma suspect	NTG^*	POAGxy^†	Total
Male (age;yrs)	20 (44)	49 (51)	19 (57)	28 (52)	116 (51)
Female	14 (53)	26 (48)	24 (64)	17 (51)	81 (55)
Total	34 (48)	75 (50)	43 (61)	45 (52)	197 (53)

^* NTG = normal tension glaucoma

^† POAG = primary open angle glaucoma.

Table 2.

VA^*, RE^†, MD^‡, PSD^§, RNFL^# average thickness, Superfield C/D ratio, OCT^Π C/D ratio in each group

	Normal		Glaucoma suspect		NTG			POAG			P-value^
	M	F	M	F	M		F	M		F	P-value^
VA	1.0±0.00	1.0±0.00	0.98±0.07	0.99±0.04	0.85±0.24	0.7	71±0.27	0.83±0.	.27	0.84±0.22	<0.001
RE (D)	−1.24±2.10	−0.77±1.96	−0.54±2.16	−0.68±1.26	−0.60±1.08	−0.	25±2.37	−2.02±2	.97	−0.60±2.74	0.1219
MD (dB)	−2.19±1.12	−2.72±1.44	−1.85±1.03	−3.21±1.57	−9.35±8.75	−8.	14±5.95	−8.40±8	.48	−7.46±3.72	<0.001
PSD (dB)	1.64±1.13	1.82±1.21	1.69±1.05	2.38±1.31	5.23±4.81	4.5	50±2.74	4.28±3.	.39	4.25±2.07	<0.001
Avg.T	104.43±7.85	106.43±7.90	101.41±10.72	104.06±9.58	85.26±18.16	6 87.7	75±13.51	82.01±21	1.63	89.36±22.06	<0.001
S.C/D	0.36±0.08	0.37±0.05	0.61±0.11	0.61±0.14	0.78±0.13	0.7	72±0.09	0.74±0.	.16	0.64±0.17	<0.001
O.C/D	0.58±0.15	0.58±0.11	0.68±0.11	0.69±0.14	0.82±0.09	0.7	78±0.11	0.79±0.	.14	0.72±0.16	<0.001

^* VA = visual acuity

^† RE= refractive error (diopter)

^‡ MD = mean deviation; nerve fiber layer

^Π OCT = optical coherence tomography

^** =statistical significance was tested by ANOVA; NTG = normal tension glaucoma; POAG = primary open angle glaucoma.

Table 3.

Comparison of mean C/D ratio between Superfield and OCT* in normal, glaucoma suspect, NTG^† and POAG^‡

	Superfield	OCT	Superfield-OCT	P-value^§
Normal	0.36±0.07	0.58±0.13	−0.22±0.12	<0.001
Glaucoma suspect	0.61±0.12	0.69±0.12	−0.07±0.09	<0.001
NTG	0.75±0.11	0.80±0.10	−0.05±0.07	<0.001
POAG	0.70±0.17	0.76±0.15	−0.06±0.08	<0.001
Total	0.61±0.18	0.71±0.15	−0.09±0.10	<0.001

^* OCT = optical coherence tomography

^† NTG = normal tension glaucoma

^‡ POAG = primary open angle glaucoma

^§ P-value = statistical significance was tested by paired t-test.

Table 4.

Comparison of mean C/D ratio between normal and glaucomatous group using Superfield and OCT*

	Normal	Glaucomatous group	P-value^†
Superfield	0.36±0.07	0.67±0.14	<0.001
OCT	0.58±0.13	0.74±0.13	<0.001

^* OCT = optical coherence tomography

^† P-value = statistical significance was tested by student's t-test.

Table 5.

Comparison of mean C/D ratio by p value* between glaucoma suspect, NTG^† and POAG^‡ using Superfield and OCT^§

	Superfield		OCT
	Glaucoma suspect	NTG	Glaucoma suspect	NTG
NTG	p<0.001		p<0.001	
POAG	p=0.0029	p=0.2849	p=0.0046	p=0.4764

C/D ratios of NTG and POAG were greater than glaucoma suspect using Superfield and OCT and was statistically significant, but there was no statistical significant difference between C/D ratio of NTG and POAG using Superfield and OCT by Scheffe multiple comparison test; * = statistical significance was tested by ANOVA

^† NTG = normal tension glaucoma

^‡ POAG = primary open angle glaucoma

^§ OCT = optical coherence tomography.

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