Analysis of retinal nerve fiber layer and optic nerve head in glaucoma with different reference plane offsets, using optical coherence tomography.
OBJECTIVE
To evaluate the performance of retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters analyzed with different offsets of reference plane in detecting early glaucomatous changes and in correlation with visual function using optical coherence tomography (OCT).


METHODS
This was a cross-sectional study consisting of 41 normal subjects and 30 with early and 40 with advanced glaucoma. RNFL thickness and ONH parameters were measured with reference planes positioned at 95, 150, and 205 microm above the level of retinal pigment epithelium (RPE). Discriminating power for early glaucoma detection and correlation with visual field MD for each parameter at different levels of reference plane were compared by using the analyses of area under the receiver operating characteristic curves (AUCs) and linear regression, respectively.


RESULTS
All ONH measurements were significantly different between normal and glaucoma groups, irrespective of the level of reference plane. In normal eyes, changing the reference plane position resulted in significant differences in ONH measurements. Among all the parameters examined, integrated rim volume and RNFL thickness measured at 150 microm above the RPE showed the largest AUC (0.966) for early glaucoma detection, and the strongest correlation with visual function (r = 0.793), respectively.


CONCLUSIONS
OCT analysis of the ONH and RNFL is useful for early glaucoma detection. Among the three reference planes examined in this study, measurements analyzed at 150 microm above the RPE demonstrated the best performance for glaucoma detection and correlation with visual function. Compared with ONH measurements, RNFL thickness may be a better indicator, reflecting retinal ganglion cell function and monitoring disease progression.
Leung
Christopher Kai-shun
CK
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Sham Shui Po, Hong Kong, People's Republic of China. tlims00@hotmail.com
Chan
Wai-Man
WM
Hui
Yung-Lam
YL
Yung
Wing-Ho
WH
Woo
Jackson
J
Tsang
Moon-Kwong
MK
Tse
Kwok-Kay
KK
D003430:Cross-Sectional Studies; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis; D014794:Visual Fields