Ability of Stratus OCT to identify localized retinal nerve fiber layer defects in patients with normal standard automated perimetry results.
OBJECTIVE
To evaluate the ability of Stratus optical coherence tomography (OCT; Carl Zeiss Meditec, Dublin, CA) with its internal normative database to discriminate between healthy eyes and eyes with a localized retinal nerve fiber layer (RNFL) defect not accompanied by a perimetric defect according to standard automated perimetry (SAP) (i.e., a preperimetric localized RNFL defect).


METHODS
Data were retrospectively reviewed from 49 eyes of 49 subjects with preperimetric localized RNFL defects, and 49 healthy control eyes of 49 age-matched subjects, with classification into each group based primarily on red-free fundus photography


RESULTS
The sensitivity and specificity of various OCT RNFL thickness parameters for identifying subjects with preperimetric localized RNFL defects was determined. In addition, the topographic relationship between the OCT-measured RNFL thickness and the localized RNFL defect location according to red-free fundus photography (i.e., the red-free RNFL defect) was examined. results. The sensitivity of the Stratus OCT RNFL thickness parameters ranged from 2.0% to 40.8%. The highest sensitivity was yielded using a criterion of > or =1 clock hour that were abnormal at the 5% level, which had a specificity of 85.7%. The OCT-measured RNFL thickness showed excellent topographic agreement with the red-free RNFL defect location.


CONCLUSIONS
Although the sensitivity of current Stratus OCT RNFL thickness parameters is low for preperimetric localized RNFL defects, it appears that OCT has the potential to recognize such defects. Further study is needed to develop new analytical methods that will increase OCT sensitivity for identifying preperimetric localized RNFL damage.
Kim
Tae-Woo
TW
Department of Ophthalmology, Seoul National University College of Medicine, Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyunggi-do 463-707, Korea. twkim7@snu.ac.kr
Park
Un-Chul
UC
Park
Ki Ho
KH
Kim
Dong Myung
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010781:Photography; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D012607:Scotoma / Q000175:diagnosis; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields