Comparison of retinal nerve fiber layer thickness values using Stratus Optical Coherence Tomography and Heidelberg Retina Tomograph-III.
OBJECTIVE
To evaluate the usefulness of retinal nerve fiber layer (RNFL) thickness measurements using the Heidelberg Retina Tomograph-III (HRT-III) in normal, ocular hypertensive, and glaucomatous eyes and compare the thickness measurements using HRT-III and Stratus Optical Coherence Tomography-3 (OCT-3).


METHODS
Sixty-nine normal eyes, 60 eyes ocular hypertensive, and 111 glaucomatous were included. All participants underwent visual field, HRT-III, and OCT-3 examinations on the same day. Patients were classified into 3 groups according to intraocular pressure and visual field damage. The sensitivity/specificity of RNFL thickness measurements and RNFL thickness classifications using HRT-III and OCT-3 were calculated. The sensitivity/specificity of the height variation contour (HVC) from the HRT-III were calculated. The receiver operating characteristic curves (ROC) and areas under the ROC were plotted. Agreement was calculated using Bland-Altman method and the kappa coefficient.


RESULTS
The RNFL thickness sensitivity/specificity were 32.4%/87%, for the HRT-III and 72.97%/81.15% for the OCT-3 in relation to the glaucoma diagnosis (least specific criteria). The RNFL thickness sensitivities/specificities were lower in early glaucoma. The areas under the ROC for RNFL measurements were 0.72 using HRT-III, 0.86 with OCT-3 (P=0.001), and 0.54 for the HVC. The RNFL classification kappa coefficient was 0.36. Bland-Altman analysis confirmed that the RNFL measurements were not interchangeable.


CONCLUSIONS
The sensitivity of RNFL damage detection using HRT-III was lower compared with OCT-3, especially in early glaucoma. RNFL thickness agreement between HRT-III and OCT-3 was only fair. HVC was not useful for glaucoma detection.
Moreno-Montañés
Javier
J
Department of Ophthalmology, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. jmoreno@unav.es
Antón
Alfonso
A
García
Noelia
N
Olmo
Natalia
N
Morilla
Antonio
A
Fallon
Mónica
M
D000328:Adult; D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis; D009887:Ophthalmoscopy / Q000379:methods*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields