Evaluation of Nerve Fiber Layer Assessment

Sommer, Alfred; Quigley, Harry A.; Robin, Alan L.; Miller, Neil R.; Katz, Joanne; Arkell, Sheila

doi:10.1001/archopht.1984.01040031430017

Cited by 195 publications

(82 citation statements)

References 11 publications

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“…17 Conventional cpRNFL measurements have a sensitivity range from 56.5 to 85.9% and a specificity range from 80.0 to 97.4% for detecting localized RNFL defects. 7,8,19,20 In this study, the significance map (sensitivity 98.4%, specificity 88.9%, and AUC 0.937) and the thickness map (sensitivity 96.9%, specificity 86.1%, and AUC 0.915) according to the abnormal RNFL criteria showed a superior performance for detecting the localized RNFL defects.…”

Section: Discussionmentioning

confidence: 42%

“…16 RNFL photography has proven to be the most useful means of detecting RNFL defects. 17 However, RNFL photographs visualize RNFL defects only as areas of reduced optical reflectance compared with thicker areas of the RNFL, and it is difficult to quantify the thickness of the RNFL defect. 18 SD-OCT with high scan speed and resolution provides a three-dimensional RNFL image as a form of topographic RNFL map.…”

Section: Discussionmentioning

confidence: 45%

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Diagnostic ability of retinal nerve fiber layer maps to detect localized retinal nerve fiber layer defects

Shin

Uhm

Lee

et al. 2013

Eye

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Purpose To evaluate and compare the diagnostic ability of spectral domain optical coherence tomography (SD-OCT) for detecting localized retinal nerve fiber layer (RNFL) defects in topographic RNFL maps and circumpapillary RNFL (cpRNFL) thickness measurements. Methods Sixty-four eyes with localized RNFL defects in red-free RNFL photographs and 72 healthy eyes were included. All participants were imaged with SD-OCT. The area and angular width of the localized RNFL defects were measured with ImageJ software on RNFL thickness map, significance map (yellow pixels, o5% level), and red-free RNFL photographs. The sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs) were calculated for cpRNFL thickness, macular inner retina thickness, and RNFL maps (thickness, significance) according to the quantitative measurements and a o5% level of classification to distinguish eyes with localized RNFL defects from healthy eyes. Results RNFL thickness map (sensitivity 96.9-98.4%, specificity 86.1-98.6%, and AUCs 0.915-0.992) and significance map (sensitivity 96.9-98.4%, specificity 88.9-95.8%, and AUCs 0.937-0.983) showed superior performance in detecting localized RNFL defects compared with other parameters (P-value 0.001-0.024) except for 36 sector cpRNFL thickness (sensitivity 92.2%, specificity 87.5%, and AUCs 0.898; P-value 0.080-0.545). The sensitivity for detecting RNFL defects was related to the angular width, area, and depth of the RNFL defects in the cpRNFL (4 sector, 12 sector) and macular inner retinal measurements. RNFL thickness and significance maps showed a constant sensitivity regardless of variations in angular width, area, and depth of the RNFL defects. Conclusion RNFL thickness and significance maps could be used to distinguish eyes with localized RNFL defects from healthy eyes more effectively than cpRNFL thickness and macular inner retina thickness measurements.

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 45%

Diagnostic ability of retinal nerve fiber layer maps to detect localized retinal nerve fiber layer defects

Shin

Uhm

Lee

et al. 2013

Eye

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“…[1][2][3][4] Before OCT and other imaging techniques, 20 in order to monitor RNFL changes, clinicians depended on ophthalmoscopy, red-free fundus photographs 21 in vivo, or histological examination of the RNFL and ONH from enucleated eyes or post-mortem. 2 Quigley and Sommer 22 gave a detailed description on 'how to use the nerve fibre layer examination in the management of glaucoma'.…”

Section: Glaucoma and The Rnflmentioning

confidence: 42%

How strong is the relationship between glaucoma, the retinal nerve fibre layer, and neurodegenerative diseases such as Alzheimer’s disease and multiple sclerosis?

Jones-Odeh

Hammond

2015

Eye

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Glaucoma is a neurodegenerative disorder with established relationships with ocular structures such as the retinal nerve fibre layer (RNFL) and the ganglion cell layer (GCL). Ocular imaging techniques such as optical coherence tomography (OCT) allow for quantitative measurement of these structures. OCT has been used in the monitoring of glaucoma, as well as investigating other neurodegenerative conditions such as Alzheimer's disease (AD) and multiple sclerosis (MS). In this review, we highlight the association between these disorders and ocular structures (RNFL and GCL), examining their usefulness as biomarkers of neurodegeneration. The average RNFL thickness loss in patients with AD is 11 μm, and 7 μm in MS patients. Most of the studies investigating these changes are cross-sectional. Further longitudinal studies are required to assess sensitivity and specificity of these potential ocular biomarkers to neurodegenerative disease progression. Eye (2015Eye ( ) 29, 1270Eye ( -1284 doi:10.1038/eye.2015; published online 4 September 2015 IntroductionGlaucoma is a neurodegenerative optic neuropathy manifesting with progressive retinal ganglion cell (RGC) and axonal loss, which can result in visual field defects and blindness because of permanent cellular and neuronal damage. Subjective clinical examination of the optic nerve head (ONH) allows for assessment and monitoring of the structural changes associated with glaucoma. However, objective detection of defects in the peripapillary retinal nerve fibre layer (RNFL) by ophthalmoscopy is difficult. The relationship between glaucoma progression and the structural changes observed at the ONH, RGC layer, and RNFL in glaucoma is well established. [1][2][3][4] Early diagnosis and treatment of glaucoma is vital to maintain visual field, as loss of RGCs is irreversible, 5 and even before any detectable visual field defects, there is a substantial loss of RGCs. Morphological abnormalities can develop 3-5 years before any functional loss is detected. 6 Since the introduction of ocular imaging techniques such as optical coherence tomography (OCT), peripapillary RNFL thickness measurements have been used for the detection and monitoring of glaucoma. 7,8 However, the use of OCT has extended beyond RNFL measurements for glaucoma, and has also been used in the investigation of other neurodegenerative disorders such as Alzheimer's disease (AD) 9-11 and multiple sclerosis (MS). [12][13][14] In addition, given the similarities of brain and retinal foetal angiogenesis, 15,16 retinal microvasculature has also been investigated as a biomarker of changes in cerebral vasculature and cognitive decline. [17][18][19] In this review, we examine the relationships between glaucoma, neurodegenerative disease, and cognitive impairment, and the use of RNFL thickness and RGC loss as potential ocular biomarkers for neurodegenerative disorders such as AD and MS. We review the strength of associations between RNFL and RGC and Eye (2015Eye ( ) 29, 1270Eye ( -1284Eye ( © 2015 Macmillan Publis...

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“…Several previous studies have shown that patients with advanced glaucoma have an increased risk of blindness [13][14][15][16][17] and that late attendance is a significant risk for subsequent blindness. 9,11 The present study attempts to elucidate the risk factors associated with late presentation in a Ghanaian population.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of risk factors for advanced glaucoma in Ghanaian patients

Ntim-Amponsah

Amoaku

Ewusi

et al. 2004

Eye

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Purpose This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. Methods A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. Results Univariate analysis showed that initial IOP431 mmHg, age of 4 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP431 mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95% CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95% CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones Conclusions Subjects with initial IOP431 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOPo32 mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects.

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Evaluation of Nerve Fiber Layer Assessment

Cited by 195 publications

References 11 publications

Diagnostic ability of retinal nerve fiber layer maps to detect localized retinal nerve fiber layer defects

Diagnostic ability of retinal nerve fiber layer maps to detect localized retinal nerve fiber layer defects

How strong is the relationship between glaucoma, the retinal nerve fibre layer, and neurodegenerative diseases such as Alzheimer’s disease and multiple sclerosis?

Evaluation of risk factors for advanced glaucoma in Ghanaian patients

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