Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage.
OBJECTIVE
Several cross-sectional studies have demonstrated the capability of optical coherence tomography (OCT) to detect glaucomatous changes. OCT enables posterior pole scanning of three regions: macula, peripapillary, and optic nerve head (ONH). This study compared the ability of each region to detect glaucomatous damage.


METHODS
Retrospective observational cross-sectional study.


METHODS
The study included 37 normal (37 subjects) and 37 glaucomatous eyes (26 subjects) that had comprehensive ocular examination, reliable and reproducible Swedish interactive thresholding algorithm standard 24-2 perimetry, and Stratus OCT scanning of macula, peripapillary, and ONH regions on the same visit. Optical nerve head (ONH) appearance did not form part of the inclusion criteria. The main outcome measure, was area under receiver operating characteristic curves (AROCs) that was calculated for each scanning region for distinguishing between normal and glaucomatous eyes.


RESULTS
The highest AROCs for distinguishing between groups were for ONH parameters (rim area = 0.97, horizontal integrated rim width = 0.96, vertical integrated rim area = 0.95) and peripapillary nerve fiber layer (NFL) thickness (0.94) followed by macular volume and thickness (both 0.80). A statistically significant difference existed in ONH and NFL AROCs when compared with macular AROCs (P < or = .007, for both)


CONCLUSIONS
OCT ONH and NFL parameters provided similar discrimination capabilities between healthy eyes and those of glaucoma patients and superior discrimination capabilities when compared with macular parameters.
Wollstein
Gadi
G
UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
Ishikawa
Hiroshi
H
Wang
Jiping
J
Beaton
Siobahn A
SA
Schuman
Joel S
JS
D000465:Algorithms; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008266:Macula Lutea / Q000473:pathology*; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields