Comparison of macular and peripapillary measurements for the detection of glaucoma

Leung, Christopher Kai-Shun; Chan, Wai‐Man; Yung, Wing‐Ho; Ng, Alan Ck; Woo, Jackson; Tsang, Moon-Kong; Tse, Raymond Kwok Kay

doi:10.1016/j.ophtha.2004.10.020

Cited by 291 publications

(192 citation statements)

References 25 publications

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“…Based on the area under the receiver operating characteristic curve (AROC), some studies have shown the overall RNFL thickness average to be the best diagnostic parameter. 11,13,14,16,19 Other studies have shown the inferior 10,17,20 or superior 21 quadrant RNFL thickness average to be the best, in agreement with clinical observation that glaucomatous optic nerve damage seems to begin in the inferotemporal or superotemporal area. [22][23][24] It is logical that optimal glaucoma detection might best employ a combination of several parameters.…”

supporting

confidence: 76%

“…It will also be used in comparative studies with parameters generated by other instruments, such as scanning laser topography and scanning laser polarimetry. Previous comparative studies used only the best single parameter to evaluate the diagnostic performance of OCT. 10,11,13,14,16,17,[19][20][21] This underestimates the diagnostic power of OCT. The OSI combination will significantly improve OCT's diagnostic performance in both clinical studies and clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Measurements of the circumpapillary RNFL are reproducible [7][8][9] and useful in the early diagnosis of glaucoma. [10][11][12][13][14][15][16][17][18][19] Stratus (Carl Zeiss Meditec, Inc., Dublin, CA) is the most widely used OCT system for glaucoma diagnosis. Stratus measures the RNFL thickness profile along a 3.4-mm-diameter circle around the optic disc.…”

mentioning

confidence: 99%

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Combining Nerve Fiber Layer Parameters to Optimize Glaucoma Diagnosis with Optical Coherence Tomography

Lu¹,

Wang²,

Varma³

et al. 2008

Ophthalmology

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Purpose-To identify the best combination of Stratus optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness parameters for the detection of glaucoma. Design-Observational cross-sectional study.Participants-Eighty-nine age-matched normal and perimetric glaucoma participants enrolled in the Advanced Imaging for Glaucoma Study.Methods-The Zeiss Stratus OCT system was used to obtain the circumpapillary RNFL thickness in both eyes of each participant. Right and left eye clock-hour data are analyzed together, assuming mirror-image symmetry. The RNFL diagnostic parameters were combined using either or-logic or and-logic approaches.Main Outcome Measures-Area under the receiver operating characteristic curve (AROC), sensitivity, and specificity are used to evaluate diagnostic performance.Results-Overall average RNFL thickness has the highest AROC value (0.89) of all single parameters evaluated, followed by the inferior and superior quadrants (0.88 and 0.86, respectively). The clock hours with the best AROC values are in the inferior and superior quadrants. The highest AROC (0.92) was achieved by the or-logic combination of overall, inferior, and superior quadrant RNFL thicknesses. The 3-parameter combination was significantly better than the overall average alone (P = 0.01) The addition of more quadrants or clock hours to the combination reduced diagnostic performance.Conclusions-The best stand-alone diagnostic strategy for Stratus OCT RNFL data is to classify an eye as glaucomatous if the overall, inferior quadrant, or superior quadrant RNFL thickness average is below normal.Glaucoma is an optic neuropathy characterized by irreversible loss of neural tissue and visual field (VF). Currently, definitive glaucoma diagnosis is based on VF testing. However, between 30% and 50% of the ganglion cells may be lost before abnormalities appear in perimetric Optical coherence tomography, first described by Huang et al, 4 is the only imaging modality with sufficiently fine depth resolution to measure the RNFL thickness directly. Measurements of the circumpapillary RNFL are reproducible 7-9 and useful in the early diagnosis of glaucoma. [10][11][12][13][14][15][16][17][18][19] Stratus (Carl Zeiss Meditec, Inc., Dublin, CA) is the most widely used OCT system for glaucoma diagnosis. Stratus measures the RNFL thickness profile along a 3.4-mm-diameter circle around the optic disc. Based on the profile, the averages of overall, quadrant, and clockhour RNFL thickness are computed and displayed. At present, the clinician has no clear guideline on whether one, several, or all of these diagnostic parameters should be used in the clinical diagnosis of glaucoma. Based on the area under the receiver operating characteristic curve (AROC), some studies have shown the overall RNFL thickness average to be the best diagnostic parameter. 11,13,14,16,19 Other studies have shown the inferior 10,17,20 or superior 21 quadrant RNFL thickness average to be the best, in agreement with clinical observation that glaucomatous optic...

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supporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Combining Nerve Fiber Layer Parameters to Optimize Glaucoma Diagnosis with Optical Coherence Tomography

Lu¹,

Wang²,

Varma³

et al. 2008

Ophthalmology

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“…Our study with SD OCT shows that although the performance of macular parameters improved compared to stratus OCT (thus corroborating with Zeimer's hypothesis) [3] , they did not outperform RNFL parameters in the diagnostic ability to detect early glaucoma [15] . This necessitates development of better OCT scanning techniques and segmentation algorithms to provide more accurate macular measurements.…”

Section: Discussionsupporting

confidence: 86%

Diagnostic utility of RNFL Thickness and Macular GCC Thickness in Primary Open Angle Glaucoma using Spectral Domain Optical Coherence Tomography in South Indian patients

Sidhan¹

2017

jmscr

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(-6.1 ± 3.5) and pattern standard deviation value of (5.3 ± 3.3). Significant differences between glaucoma and normal subjects were found for all tomographic parameters. The best parameters based on Receiver operating characteristic curves and sensitivity at 95% specificity were RNFL-Average (AROC, 0.960; sensitivity, 80%) and 0.912; sensitivity, 80%). Conclusions: Both retinal nerve fibre layer thickness parameters and macular Ganglion cell complex parameters showed good diagnostic abilities in the diagnosis of early glaucoma using the spectral domain Optical Coherence Tomography. Better performance of macular parameters (compared to previous observations using older -Time Domain-Optical Coherence Tomography) were noted in the current study, however they did not outperform RNFL parameters.

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“…Initial studies examining the role of macular thickness measurements in glaucoma found that quantification of full retinal thickness was helpful for glaucoma diagnosis (Giovannini et al, 2002;Greenfield et al, 2003;Guedes et al, 2003;Lederer et al, 2003;Leung et al, 2005;Medeiros et al, 2005b). Though as thickness of the outer retina is largely unchanged in glaucoma, inclusion of outer retinal layers, such as the outer plexiform layer, outer nuclear layer, and photoreceptor segment layers, may reduce the sensitivity with which glaucomatous damage can be detected.…”

Section: Imaging the Maculamentioning

confidence: 99%

Strategies to improve early diagnosis in glaucoma

Tatham¹,

Medeiros²,

Zangwill³

et al. 2015

Progress in Brain Research

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Early diagnosis and treatment of glaucoma is important to reduce the risk of progressive and irreversible visual loss. The key to diagnosis is recognition of morphological changes to the optic nerve head and retinal nerve fiber layer, but in some patients, functional abnormalities are detected first. This review describes recent innovations with the potential to improve the early detection of glaucoma. Developments in imaging include novel optic nerve head metrics such as Bruch's membrane opening-minimum rim width, enhanced ability to quantify inner layers of the glaucomatous macula, and ability to image deep optic nerve head structures, including the lamina cribrosa. Developments in detection of early glaucomatous functional loss include novel perimetric tests using frequency-doubling technology and flicker-defined form stimuli. Methods to combine results of structural and functional assessments are also presented that may improve early detection of glaucoma. KeywordsGlaucoma, Optical coherence tomography, OCT, Perimetry, Spectral domain, Early diagnosis Glaucoma is a leading cause of blindness, affecting more than 70 million people worldwide, of whom approximately 10% are bilaterally blind (Quigley and Broman, 2006). Glaucomatous visual losses can be prevented with early diagnosis and treatment; however, affected individuals are typically asymptomatic until later stages of the disease and a large proportion of those affected remain undiagnosed. Population-level surveys suggest only 10-50% of people with glaucoma are aware that they have the condition and consequently there are a large number of people Progress in Brain Research, Volume 221, ISSN 0079-6123, http://dx

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Comparison of macular and peripapillary measurements for the detection of glaucoma

Cited by 291 publications

References 25 publications

Combining Nerve Fiber Layer Parameters to Optimize Glaucoma Diagnosis with Optical Coherence Tomography

Combining Nerve Fiber Layer Parameters to Optimize Glaucoma Diagnosis with Optical Coherence Tomography

Diagnostic utility of RNFL Thickness and Macular GCC Thickness in Primary Open Angle Glaucoma using Spectral Domain Optical Coherence Tomography in South Indian patients

Strategies to improve early diagnosis in glaucoma

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