Comparison of RNFL Thickness Measured by Two Different Kind of OCT in NTG Patients

Kyung-Eun Han; Roo Min Jun; Kyu-Ryong Choi

doi:10.3341/jkos.2009.50.12.1853

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Han, Jun, and Choi: Comparison of RNFL Thickness Measured by Two Different Kind of OCT in NTG Patients

Original Article

J Korean Ophthalmol Soc 2009;50(12):1853-1859.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.12.1853

Comparison of RNFL Thickness Measured by Two Different Kind of OCT in NTG Patients

Kyung-Eun Han, MD, Roo Min Jun, MD, Kyu-Ryong Choi, MD

Department of Ophthalmology, Ewha Womans University School of Medicine, The Institue of Ophthalmology and Optometry, Seoul, Korea

Address reprint requests to Kyu-Ryong Choi, MD, Department of Ophthalmology, Ewha Womans University School of Medicine, Mok-dong Hospital #911-1 Mok 6-dong, Yangcheon-gu, Seoul 158-710, Korea Tel: 82-2-2650-5154, Fax: 82-2-2654-4334, E-mail: ckrey02@mm.ewha.ac.kr

Received 4 March 2009 Accepted 25 August 2009

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

To compare retinal nerve fiber layer (RNFL) thicknesses with two types of OCT in patients with normal tension glaucoma (NTG) and early NTG.

Methods

We evaluated the RNFL thicknesses of 101 eyes in 101 patients using Fourier domain OCT and time domain OCT. We compared the measured RNFL thicknesses according to the subject groups and the type of OCT. We calculated the area under the receiver operating characteristic curve (AUROC) to determine the best parameters with which to make a diagnosis of NTG or early NTG.

Results

The RNFL thicknesses measured by 3D OCT were greater than that measured by Stratus OCT for all of the groups. The RNFL thickness in each group was statistically significantly different in the superior quadrant, the inferior quadrant, and the 1 and 2 o' clock positions when using 3D OCT. It was statistically significantly different in the superior, temporal, and inferior quadrant, as well as the 1, 7, 8, 9, 10 and 11 o' clock positions when using Stratus OCT. The largest AUROC was found for the inferior quadrant thickness (0.773) using Stratus OCT and the 1 o' clock thickness (0.712) using 3D OCT when comparing normal patients and those with suspected NTG. The largest AUROC was found for the inferior quadrant thickness (0.888) using Stratus OCT and the superior quadrant thickness (0.802) using 3D OCT when comparing normal patients and those with early NTG. The AUROC was greater in the temporal and inferior quadrants and in the 6, 7, 8, 9 and 10 o' clock thicknesses using Stratus OCT compared to the 3D OCT in differentiating patients with suspected NTG from normal patients. The AUROC found using 3D OCT compared to the Stratus OCT was greater only in the 1 o' clock thickness (p<0.05). The AUROC differentiating patients with early NTG from normal patients was greater in the temporal, inferior, nasal quadrant, and in the 5, 6, 7, 8, 9, 10 and 11 o' clock positions using the Stratus OCT compared to the 3D OCT (p<0.05).

Conclusions

The RNFL thicknesses measured using 3D OCT were generally greater than those measured using Stratus OCT. The largest AUROCs for differentiating patients with suspected NTG and early NTG from normal patients were in the 1 o' clock position and the superior quadrant RNFL thickness using 3D OCT and the inferior quadrant RNFL thickness using Stratus OCT. The AUROCs using the 3D OCT parameters were less than those from the Stratus OCT when comparing normal patients and those with suspected or early NTG.

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Keywords: Fourier domain, Normal tension glaucoma, Optical coherence tomography, Time domain

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Table 1.

Demographics of patients (Mean± SD)

	Normal	NTG suspect	Early NTG	p-value^*
No. of eye	31	40	30
Age	47.6±10.8	48.6±9.8	53.3±9.9	0.225
M: F	25: 13	18: 14	16: 15
Refrective errors (D)	−2.64±2.431	−2.56±2.523	−1.36±2.430	0.265
IOP (mmHg)	15.7±3.1	15.0±2.2	14.4±2.8	0.236
MD (dB)	−0.03±1.34	−0.29±1.14	−3.16±2.67	<0.001
PSD (dB)	1.54±0.79	1.07±0.50	4.61±3.41	<0.001

^* One-way ANOVA.

Table 2.

Comparison of the retinal nerve fiber thickness by 3D OCT among the normal, normal tension glaucoma (NTG) suspect and early normal tension glaucoma (NTG) groups (Mean± SD)

	Normal	NTG^† suspect	Early NTG	p-value^*
Superior	132.1±13.97	124.0±13.26	113.6±18.64	<0.001
Temporal	83.0±15.51	87.6±14.40	84.5±15.20	0.512
Inferior	128.4±14.26	131.0±20.49	117.0±21.44	0.022
Nasal	92.3±16.15	94.9±20.23	92.0±18.70	0.816
1-o'clock	129.3±21.28	116.7±19.98	106.4±22.26	0.010
2-o'clock	106.0±20.93	108.0±24.59	103.4±21.79	0.761
3-o'clock	78.3±14.16	83.6±16.56	84.8±17.75	0.319
4-o'clock	92.6±20.12	93.2±22.57	88.4±19.95	0.673
5-o'clock	116.3±23.39	119.6±28.89	107.6±24.07	0.221
6-o'clock	130.7±33.11	139.7±26.78	124.0±27.10	0.147
7-o'clock	133.4±18.91	133.8±23.73	119.6±32.68	0.080
8-o'clock	84.2±17.09	89.8±15.53	85.2±15.34	0.384
9-o'clock	72.3±14.58	79.8±15.99	75.4±12.85	0.167
10-o'clock	92.7±19.24	93.4±16.38	93.2±22.23	0.989
11-o'clock	134.0±24.16	129.9±20.95	120.6±25.87	0.122
12-o'clock	133.1±20.71	125.5±18.90	113.9±22.62	0.005

^* One-way ANOVA test

^† NTG=normal tension glaucoma.

Table 3.

Comparison of the retinal nerve fiber thickness by Stratus OCT among the normal, normal tension glaucoma (NTG) suspect and early normal tension glaucoma (NTG) groups (Mean± SD)

	Normal	NTG^† suspect	Early NTG	p-value^*
Superior	120.2±16.71	112.6±15.02	104.2±25.88	0.016
Temporal	81.3±19.70	68.0±12.99	66.7±23.49	0.002
Inferior	124.5±11.66	125.5±21.12	107.1±26.91	0.033
Nasal	68.4±14.66	67.4±16.73	65.3±28.36	0.960
1-o'clock	110.1±22.45	100.1±18.43	90.4±31.84	0.015
2-o'clock	75.5±21.81	75.7±18.88	67.7±26.37	0.303
3-o'clock	54.3±14.28	56.3±16.50	55.3±17.83	0.647
4-o'clock	70.4±15.65	70.5±19.20	70.0±22.81	0.951
5-o'clock	104.0±19.14	107.4±25.71	99.3±22.20	0.682
6-o'clock	131.1±18.89	134.8±32.71	122.0±25.94	0.436
7-o'clock	147.1±24.79	134.0±19.45	117.7±36.51	0.001
8-o'clock	85.4±21.18	71.2±13.32	67.1±20.21	<0.001
9-o'clock	65.6±15.51	54.0±10.74	56.0±14.56	0.005
10-o'clock	95.2±24.54	78.6±18.68	81.5±20.60	0.015
11-o'clock	133.9±26.13	121.2±22.74	113.2±30.40	0.020
12-o'clock	116.5±24.06	115.5±21.60	102.7±33.61	0.119

^* One-way ANOVA test

^† NTG=normal tension glaucoma.

Table 4.

Comparison of measured retinal nerve fiber layer thickness by Stratus OCT and 3D OCT in each group (Mean± SD)

	Normal			NTG^† suspect			Early NTG
	Strstus OCT	3D OCT	p-value^*	Strstus OCT	3D OCT	p-value^*	Strstus OCT	3D OCT	p-value^*
Superior	120.2	128.4	0.004	112.6	123.8	<0.001	104.2	117.1	0.005
Temporal	81.3	85.1	0.272	68.0	87.8	<0.001	66.7	93.2	<0.001
Inferior	124.5	123.8	0.842	125.5	130.6	0.018	107.1	121.8	0.001
Nasal	68.4	90.6	<0.001	67.4	94.6	<0.001	65.3	84.8	<0.001
1-o'clock	110.1	125.4	<0.001	100.1	117.0	<0.001	90.4	110.6	<0.001
2-o'clock	75.5	104.1	<0.001	75.7	107.4	<0.001	67.7	104.7	<0.001
3-o'clock	54.3	78.4	<0.001	56.3	83.2	<0.001	55.3	84.8	<0.001
4-o'clock	70.4	89.4	<0.001	70.5	93.3	<0.001	70.0	90.5	<0.001
5-o'clock	104.0	109.9	0.116	107.4	120.6	<0.001	99.3	114.2	<0.001
6-o'clock	131.1	124.5	0.200	134.8	139.0	0.027	122.0	130.9	0.026
7-o'clock	133.5	147.1	0.001	134.0	132.5	0.005	117.7	120.5	0.505
8-o'clock	85.4	87.7	0.550	71.2	90.9	<0.001	67.1	84.0	<0.001
9-o'clock	65.6	73.2	0.028	54.0	77.5	<0.001	56.0	76.0	<0.001
10-o'clock	95.2	94.4	0.852	78.6	95.2	<0.001	81.5	94.7	0.001
11-o'clock	133.9	131.9	0.633	121.2	129.7	<0.027	113.2	124.1	0.017
12-o'clock	116.5	127.7	0.009	115.5	124.9	0.005	102.7	116.4	0.042

^* Paired t-test

^† NTG=normal tension glaucoma.

Table 5.

The AUROC for discriminating ability between normal and normal tension glaucoma (NTG) suspect and between normal and early normal tension glaucoma (NTG) (Mean±SD)

	AUROC^*
	Normal and NTG^† suspect			Normal and Early NTG
	Stratus OCT	3D OCT	p-value^‡	Stratus OCT	3D OCT	p-value^‡
Superior	0.759	0.688	0.521	0.812	0.802	0.701
Temporal	0.727	0.401	0.003	0.710	0.462	0.005
Inferior	0.773	0.554	<0.001	0.888	0.672	0.001
Nasal	0.652	0.556	0.348	0.627	0.487	0.038
1-o'clock	0.664	0.712	0.029	0.792	0.791	0.942
2-o'clock	0.579	0.542	0.761	0.622	0.504	0.064
3-o'clock	0.616	0.478	0.198	0.525	0.364	0.050
4-o'clock	0.677	0.586	0.309	0.658	0.557	0.083
5-o'clock	0.685	0.579	0.093	0.786	0.612	0.006
6-o'clock	0.749	0.520	0.003	0.788	0.588	0.002
7-o'clock	0.756	0.498	0.006	0.832	0.629	0.019
8-o'clock	0.746	0.369	0.007	0.709	0.468	0.014
9-o'clock	0.657	0.339	<0.001	0.682	0.400	0.004
10-o'clock	0.710	0.519	0.044	0.718	0.505	0.019
11-o'clock	0.747	0.566	0.095	0.799	0.658	0.046
12-o'clock	0.543	0.603	0.318	0.733	0.732	0.867

^* AUROC=area under receiver operating characteristic curve

^† NTG=normal tension glaucoma

^‡ DeLong and associates method.

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