Glaucoma Diagnostic Capabilities of Optic Nerve Head Parameters as Determined by Cirrus HD Optical Coherence Tomography

Sung, Kyung Rim; Na, Jung Hwa; Lee, Youngrok

doi:10.1097/ijg.0b013e318220dbb7

Cited by 81 publications

(77 citation statements)

References 24 publications

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“…SDOCT also provides a means to acquire 3D images of the optic nerve head from which parameters such as rim area, cup-to-disc ratio, and cup volume can be measured. However, in a study including 144 eyes with early glaucoma and 109 healthy controls, Sung and colleagues found cpRNFL thickness to perform better than SDOCT optic nerve head parameters (Sung et al, 2012). This was a similar finding to that of Lisboa and colleagues using CSLO (Lisboa et al, 2012) and a subsequent study by the same authors using SDOCT to quantify cpRNFL and optic nerve head parameters .…”

Section: Detecting Structural Changesupporting

confidence: 59%

“…Care should therefore be taken when interpreting the results of studies where OCT has been evaluated outside of this context. In fact, most studies examining the diagnostic ability of OCT in glaucoma have included patients with established visual field defects and relatively few have examined the utility of imaging specifically in early disease (Begum et al, 2014;Jeoung et al, 2014;Lisboa et al, 2012Lisboa et al, , 2013bSung et al, 2012;Takayama et al, 2012;Wu et al, 2012).…”

Section: Detecting Structural Changementioning

confidence: 99%

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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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Section: Detecting Structural Changesupporting

confidence: 59%

Section: Detecting Structural Changementioning

confidence: 99%

Strategies to improve early diagnosis in glaucoma

Tatham¹,

Medeiros²,

Zangwill³

et al. 2015

Progress in Brain Research

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“…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.…”

Section: Discussioncontrasting

confidence: 45%

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

Monsalve

Ferreras

Calvo

et al. 2016

Eye

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Purpose To evaluate and compare the diagnostic accuracy of the Humphrey Field Analyzer (HFA), Octopus perimetry, and Cirrus OCT for glaucomatous optic neuropathy. Methods Eighty-eight healthy individuals and 150 open-angle glaucoma patients were consecutive and prospectively selected. Eligibility criteria for the glaucoma group were intraocular pressure ≥ 21 mm Hg and glaucomatous optic nerve head morphology. All subjects underwent a reliable standard automated perimetry with the HFA and Octopus perimeter, and were imaged with the Cirrus OCT. Receiver-operating characteristic (ROC) curves were plotted for the threshold values and main indices of the HFA and Octopus, the peripapillary retinal nerve fiber layer thicknesses, and the optic nerve head parameters. Sensitivities at 85 and 95% fixedspecificities were also calculated. The best areas under the ROC curves (AUCs) were compared using the DeLong method. Results In the glaucoma group, mean deviation (MD) was − 5.42 ± 4.6 dB for HFA and 3.90 ± 3.6 dB for Octopus. The MD of the HFA (0.966; Po0.001), mean sensitivity of the Octopus (0.941; Po0.001), and average cup-todisc (C/D) ratio measured by the Cirrus OCT (0.958; Po0.001) had the largest AUCs for each test studied. There were no significant differences among them. Sensitivities at 95% fixed-specificity were 82% for pattern standard deviation of the HFA, 81.3% for average C/D ratio of OCT, and 80% for the MD of the Octopus. Conclusions HFA, Octopus, and Cirrus OCT demonstrated similar diagnostic accuracies for glaucomatous optic neuropathy. Visual field and OCT provide supplementary information and thus these tests are not interchangeable.

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“…3 Images with poor quality were excluded; poor quality images were those with signal strength 6, incorrect identification of the vitreoretinal surface detection algorithm in the peripapillary RNFL extracted B-scan, misidentification of Bruch's membrane termination in the horizontal and vertical optic nerve extracted B-scans, and prominent involuntary saccade during the scan. 5 The ONH en face image with optic disc margin (black circle in Fig. 1), cup margin (red circle in Fig.…”

Section: Oct Measurementmentioning

confidence: 99%

“…1,2 Recent studies have also reported that neuroretinal rim measurements by spectral-domain OCT are excellent with respect to reproducibility, glaucoma diagnostic ability, and low rate of incorrect optic disc margin detection. [3][4][5] However, only average rim areas have been assessed in previous studies, [3][4][5] with little knowledge gained concerning the glaucoma diagnostic ability of sectorial (quadrant and clock-hour) neuroretinal rim assessment as determined by OCT.…”

mentioning

confidence: 99%

Glaucoma Diagnostic Ability of Quadrant and Clock-Hour Neuroretinal Rim Assessment Using Cirrus HD Optical Coherence Tomography

Hwang

Kim

2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The aim of this study was to investigate the glaucoma diagnostic ability of quadrant and clock-hour neuroretinal rim assessment by Cirrus HD spectral-domain optical coherence tomography (OCT).METHODS. Eighty eyes of 80 glaucoma patients and 80 eyes of 80 healthy subjects were enrolled. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured by Cirrus HD-OCT. Quadrant and clock-hour rim areas and thicknesses were obtained from optic nerve head images and 3608 circumferential rim thickness curve of Cirrus HD-OCT, respectively. Area under receiver operating characteristic curves (AUCs) and sensitivities of RNFL thicknesses, rim areas, and rim thicknesses at a 90% specificity level were calculated.RESULTS. Quadrant and clock-hour rim area and thickness showed good diagnostic ability for glaucoma in all areas (AUCs, 0.877-0.969; sensitivities, 67.5%-96.3%). When the AUCs of RNFL thicknesses, rim areas, and rim thicknesses were compared, no significant difference was found in global area and superior and inferior quadrants (P > 0.05). However, in nasal and temporal quadrants, rim area and thickness had greater AUCs (AUCs, 0.919-0.945; sensitivities, 82.5%-86.3%) than RNFL thickness (AUCs, 0.749-0.776; sensitivities, 12.5%-33.8%; P < 0.001). Eyes with moderate to advanced glaucoma (mean deviation < -6 dB) had thinner RNFL than mild glaucoma (mean deviation ‡ -6 dB) in global area, superior, inferior, and temporal quadrants (P < 0.003); rim area and thickness showed no significant difference in all areas (P > 0.003).CONCLUSIONS. Neuroretinal rim assessment in nasal and temporal areas by Cirrus HD-OCT may enhance glaucoma diagnostic ability. RNFL and rim changes measured by Cirrus HD-OCT may be different according to the stages of glaucomatous damage. (Invest Ophthalmol Vis Sci.

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Glaucoma Diagnostic Capabilities of Optic Nerve Head Parameters as Determined by Cirrus HD Optical Coherence Tomography

Abstract: RNFLT was better than any tested ONH parameter when used for glaucoma discrimination, especially in patients with early-stage glaucoma and in glaucomatous patients with small optic discs.

Cited by 81 publications

References 24 publications

Strategies to improve early diagnosis in glaucoma

Strategies to improve early diagnosis in glaucoma

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

Glaucoma Diagnostic Ability of Quadrant and Clock-Hour Neuroretinal Rim Assessment Using Cirrus HD Optical Coherence Tomography

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