Ability of Cirrus HD-OCT Optic Nerve Head Parameters to Discriminate Normal from Glaucomatous Eyes

Abstract

Purpose-To determine the ability of optic nerve head (ONH) parameters measured with spectral domain Cirrus™ HD-OCT to discriminate between normal and glaucomatous eyes and to compare them to the discriminating ability of peripapillary retinal nerve fiber layer (RNFL) thickness measurements performed with Cirrus™ HD-OCT. Design-Evaluation of diagnostic test or technology.Participants-Seventy-three subjects with glaucoma and one hundred and forty-six age-matched normal subjects.Methods-Peripapillary ONH parameters and RNFL thickness were measured in one randomly selected eye of each participant within a 200×200 pixel A-scan acquired with Cirrus™ HD-OCT centered on the ONH.Main Outcome Measures-ONH topographic parameters, peripapillary RNFL thickness, and the area under receiver operating characteristic curves (AUCs).Results-For distinguishing normal from glaucomatous eyes, regardless of disease stage, the six best parameters (expressed as AUC) were vertical rim thickness (VRT, 0.963), rim area (RA, 0.962), RNFL thickness at clock-hour 7 (0.957), RNFL thickness of the inferior quadrant (0.953), vertical cup-to-disc ratio (VCDR, 0.951) and average RNFL thickness (0.950). The AUC for distinguishing between normal and eyes with mild glaucoma was greatest for RNFL thickness of clock-hour 7 (0.918), VRT (0.914), RA (0.912), RNFL thickness of inferior quadrant (0.895), average RNFL thickness (0.893) and VCDR (0.890). There were no statistically significant differences between AUCs for the best ONH parameters and RNFL thickness measurements (p > 0.05).Conclusions-Cirrus™ HD-OCT ONH parameters are able to discriminate between eyes that are normal from those with glaucoma or even mild glaucoma. There is no difference in the ability

Diagnostic ability of Humphrey perimetry, Octopus perimetry, and optical coherence tomography for glaucomatous optic neuropathy

“…This last parameter, vertical C/D ratio, had the best AUC (0.962) in a very similar study published by the same group that included 58 glaucomatous eyes and 99 controls. 42 A recent similar study 43 that included a large sample (209 glaucomatous eyes, 405 pre-perimetric glaucomatous eyes, and 109 controls) had worse results compared with our study and that of Mwanza et al 13 Only rim area presented a relatively good AUC and it was worse than that of the average RNFL thickness. One potential reason for this is that they included glaucomatous eyes at an earlier stage of the disease.…”

“…One of these tools is optical coherence tomography (OCT), which provides quantitative and reproducible measurements of the ONH parameters and peripapillary RNFL thickness. [11][12][13][14][15] Understanding their comparative roles and performance in clinical practice is key to the management of glaucoma.…”

“…[11][12][13][14][15][16][17][18][19][20] Some studies compared tests for evaluating the VF based on other stimuli than white-on-white perimetry, [21][22][23][24][25][26][27] or evaluated the structure-function relationship. [28][29][30][31][32][33] The objective of the present study was to evaluate and compare the glaucoma diagnostic accuracy of the most widely used VF testing algorithms in clinical practice (24-2 SITA Standard strategy of HFA and G1 TOP strategy of Octopus) with one of the most advanced structural imagining tests (OCT).…”

Retinal Nerve Fiber Layer Imaging with Spectral-domain Optical Coherence Tomography (OCT)—A Review of the Cirrus HD-OCT

“…The diagnostic performance for detection of glaucoma of the optic nerve head parameters has been shown to be comparable to RNFL measurements. 14 Further evaluation is needed to investigate the stability of the measurements and their application to tracking optic disc changes in glaucoma progression.…”

Shared-hole graph search with adaptive constraints for 3D optic nerve head optical coherence tomography image segmentation

“…With the increasing of intraocular pressure, the retinal nerve fiber layer (RNFL) becomes thinner. According to [14], the comparison between normal and eyes with even mild glaucoma showed significant differences in the thickness of the RNFL. On the other hand, the optic disc boundary, also called Bruch's membrane opening (BMO) showed in ONH-centered OCT image is a stability landmark, as it is unaffected by glaucomatous cupping [15].…”