Peripapillary Retinal Nerve Fiber Layer Assessment of Spectral Domain Optical Coherence Tomography and Scanning Laser Polarimetry to Diagnose Preperimetric Glaucoma

Abstract

PurposeTo compare the abilities of peripapillary retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting preperimetric glaucoma.MethodsIn a cross-sectional study, 35 preperimetric glaucoma eyes (32 subjects) and 94 control eyes (74 subjects) underwent digital optic disc photography and RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT and GDx ECC to discriminate preperimetric glaucoma eyes from control eyes was compared using area under receiver operating characteristic curves (AUC), sensitivities at fixed specificities and likelihood ratios (LR).ResultsAUC of the global average RNFL thickness of SDOCT (0.786) was significantly greater (p<0.001) than that of GDx ECC (0.627). Sensitivities at 95% specificity of the corresponding parameters were 20% and 8.6% respectively. AUCs of the inferior, superior and temporal quadrant RNFL thickness parameters of SDOCT were also significantly (p<0.05) greater than the respective RNFL parameters of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 3.3 and 4.0 while the same of GDx ECC parameters ranged between 1.2 and 2.1. LRs of within normal limits category of SDOCT parameters ranged between 0.4 and 0.7 while the same of GDx ECC parameters ranged between 0.7 and 1.0.ConclusionsAbilities of the RNFL parameters of SDOCT and GDx ECC to diagnose preperimetric glaucoma were only moderate. Diagnostic abilities of the RNFL parameters of SDOCT were significantly better than that of GDx ECC in preperimetric glaucoma.

Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015

“…In the last two decades, retinal nerve fiber layer (RNFL) and optic nerve head (ONH) imaging devices for detecting glaucoma, such as optical coherence tomography (OCT), Heidelberg retinal tomography (HRT) and scanning laser polarimetry (GDx), were introduced in ophthalmic clinical practice to identify structural damages occurring early in glaucoma. However, the performance of these tests in clinical decision-making for detecting glaucoma is still debatable [ 6 ] and since their introduction, a large number of studies have been published on their diagnostic ability [ 7 – 9 ]. With such a large amount of evidence available, a high quality of reporting is crucial for clinicians to best appreciate the potential for bias and the internal/external validity of such studies [ 10 ].…”

Significance of the disc damage likelihood scale objectively measured by a non-mydriatic fundus camera in preperimetric glaucoma

“… 6 , 24 Red free fundus photography is currently entitled as the gold standard for RNFL analysis. 25 Other objective devices available for RNFL evaluation were the scanning laser polarimetry and OCT. 26 – 29 Deleon-Ortega et al stated that similar diagnostic efficiency was found for all objective imaging techniques (HRT II, scanning laser polarimetry, and OCT), however no superiority was observed compared to the subjective assessment of the ONH stereophotography. 30 Andersson et al findings suggest that the sensitivity of MRA is superior to that of the average physician, but not including glaucoma experts.…”

Diagnostic Performance of Peripapillary Retinal Nerve Fiber Layer Thickness for Detection of Glaucoma in an Elderly Population: The ALIENOR Study

“…Quite a few casecontrol studies have already reported good discriminating performances of SD-OCT and have thus validated its usefulness in glaucoma diagnosis. [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Despite differences in study methodology design, SD-OCT machines evaluated, population sample selected or severity of glaucoma disease in each glaucoma group, all these studies have validated high diagnostic performances of OCT imaging technology with best values of AUC ranging from 0.786 to 0.978. Furthermore, the average peripapillary RNFL thickness was the most frequently described discriminating parameter followed by temporal parameters.…”

“…Numerous casecontrol studies have already shown good diagnostic performances of SD-OCT to detect glaucoma. [16][17][18][19][20][21][22][23][24][25][26][27][28][29] However, only very few studies have been performed in a population setting. [30][31][32] In a systematic review of studies on imaging technology for diagnosing glaucoma, Michelessi et al 33 highlighted high risk of bias in these case-control studies, mainly related to patient selection as defined by the QUADAS 2 quality assessment tool, and raised concerns about the applicability of these results in iovs.arvojournals.org j ISSN: 1552-5783 clinical practice.…”