Evaluation of optical coherence tomography and heidelberg retinal tomography parameters in detecting early and moderate glaucoma.
OBJECTIVE
To evaluate the relationship between optic nerve head (ONH) and peripapillary retinal nerve fiber layer (RNFL) parameters by optical coherence tomography (OCT) and confocal scanning laser ophthalmoscopy (Heidelberg retinal tomography; HRT; Heidelberg Engineering, Heidelberg, Germany) in early and moderate glaucoma and to compare several OCT-based automated classifiers with those inbuilt in HRT for detection of glaucomatous damage.


METHODS
This cross-sectional study included 60 eyes of 60 patients with glaucoma (30 early and 30 moderate visual field defects) and 60 eyes of 60 healthy subjects. All patients underwent Fast Optic Disc and Fast Peripapillary RNFL scans on the OCT and then HRT evaluation of the ONH during the same visit. Glaucoma variables obtained from OCT and HRT analyses were compared among the groups. Receiver operator characteristic (ROC) curves generated by performing linear discriminant analysis (LDA), artificial neural networks (ANNs), and classification and regression trees (CART) on OCT-based parameters were compared with the Moorfield regression analysis (MRA), R Bathija (RB), and FS Mickelberg (FSM) functions in the HRT, to classify eyes as either glaucomatous or normal.


RESULTS
No statistically significant difference was found in the disc area measured by the OCT and HRT analyses within each study group (P > 0.05). The areas under ROC curves were 0.9822 (LDF), 0.9791 (CART), and 0.9383 (ANN) as compared with 0.859 (FSM), 0.842 (RB) and 0.767 (MRA).


CONCLUSIONS
OCT-based automated classifiers performed better than HRT classifiers in distinguishing glaucomatous from healthy eyes. Such parameters should be integrated in the OCT to improve its diagnostic abilities.
Naithani
Prashant
P
Glaucoma Research Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. drprashantnaithani@yahoo.co.in
Sihota
Ramanjit
R
Sony
Parul
P
Dada
Tanuj
T
Gupta
Viney
V
Kondal
Dimple
D
Pandey
Ravindra M
RM
D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D016571:Neural Networks, Computer; D009887:Ophthalmoscopy / Q000379:methods*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D014054:Tomography; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014794:Visual Fields