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Lee, Sung, Hong, and Na: Glaucoma Diagnostic Performance of Macular and Retinal Nerve Fiber Layer by Spectral-Domain Optical Coherence Tomography
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2010; 51(9): 1250-1257.

Published online: 30 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.9.1250

Glaucoma Diagnostic Performance of Macular and Retinal Nerve Fiber Layer by Spectral-Domain Optical Coherence Tomography

Youngrok Lee, MD, Kyung Rim Sung, MD, PhD, Jung Taeck Hong, MD, Jung Hwa Na, MD

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address reprint requests to Kyung Rim Sung, MD. Department of Ophthalmology, Asan Medical Center, #388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. Tel: 82-2-3010-3680, Fax: 82-2-470-6440, sungeye@gmail.com

Received 12 May 2010       Accepted 9 June 2010

Copyright © 2010 The Korean Ophthalmological Society

Abstract

Purpose

To compare the performance of glaucoma diagnosis according to the macular and peripapillary retinal nerve fiber layer (RNFL) thicknesses, as determined by spectral domain optical coherence tomography (OCT).

Methods

Ninety-six normal, 63 early glaucoma and 37 moderate to advanced glaucomatous eyes were imaged by Cirrus OCT. The areas under the receiver operating characteristics curves (AUCs) of macular and RNFL thicknesses were calculated for discrimination of normal and glaucomatous eyes. The sensitivity and specificity of normative classification of each parameter were assessed.

Results

The glaucoma diagnostic capability determined by AUC was greater when based on the peripapillary RNFL than the macular thickness (0.914, 0.775, p<0.001). Both the early and the moderate-to-advanced group showed higher AUCs in peripapillary RNFL thickness (early glaucoma group; 0.870, 0.670, p<0.001, moderate to advanced glaucoma group; 0.990, 0.954, p=0.03). The inferior outer sector of macular thickness showed highest sensitivity among the parameters (58%).

Conclusions

Although Cirrus OCT applied to determine macular thickness did not outperform that applied to determine peripapillary RNFL thickness in glaucoma diagnosis, applying Cirrus OCT to determine both thicknesses in diagnosis may help in understanding a patient's status.

Keywords: Cirrus spectral domain Optical coherence tomography, Glaucoma, Macular thickness, Peripapillary retinal nerve fiber layer thickness

Figures and Tables

Figure 1
The correlation between average macular and peripapillary retinal nerve fiber layer thickness (µm) measured by Cirrus spectral domain optical coherence tomography.
jkos-51-1250-g001
Figure 2
The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and glaucomatous eyes (100 eyes). Sensitivities and specificities were described as percentage (%).
jkos-51-1250-g002
Figure 3
The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and early glaucomatous eyes (63 eyes). Sensitivities and specificities were described as percentage (%).
jkos-51-1250-g003
Figure 4
The receiver operating characteristic curve of average macular and peripapillary retinal nerve fiber layer thickness for discrimination between normal (96 eyes) and moderate to advanced glaucomatous eyes (37 eyes). Sensitivities and spcificities were described as percentage (%).
jkos-51-1250-g004
Table 1
Baseline characteristics of study participants
jkos-51-1250-i001

p-values were calculated by chi-square test (gender) and un-paired t-test (age, SE, VF MD, VF PSD).

*SD=standard deviation; †SE=spherical equivalent; ‡VF=visual field; §MD=mean deviation; ∥PSD=pattern standard deviation

Table 2
Macular thickness of normal and glaucomatous eyes in 9 sectors as well as average determined by Cirrus spectral domain optical coherence tomography
jkos-51-1250-i002

P-values were calculated by un-paired t-test

Table 3
Retinal nerve fiber layer thickness of normal and glaucomatous eyes in 4 quadrants, 12 clock hour sectors as well as average determined by Cirrus spectral domain optical coherence tomography
jkos-51-1250-i003

P-values were calculated by un-paired t-test

Table 4
The area under receiver operator characteristics curve (AUC) and confidence interval (CI) of macular thickness in 9 sectors as well as average for discrimination of glaucoma from normal eyes
jkos-51-1250-i004
Table 5
The area under receiver operator characteristics curve (AUC) and confidence interval (CI) of retinal nerve fiber layer thickness in 4 quadrants, 12 sectors, as well as average for discrimination of glaucoma from normal eyes
jkos-51-1250-i005
Table 6
The sensitivity and specificity (%, confidence interval) of macular thickness normative classification for glaucoma diagnosis
jkos-51-1250-i006
Table 7
The sensitivity and specificity (%, confidence interval)of retinal nerve fiber layer thickness normative classification for glaucoma diagnosis
jkos-51-1250-i007

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