Macular and peripapillary retinal nerve fiber layer measurements by spectral domain optical coherence tomography in normal-tension glaucoma.
OBJECTIVE
To evaluate and compare the glaucoma discrimination ability of macular inner retinal layer (MIRL) thickness with that of peripapillary retinal nerve fiber layer (pRNFL) thickness measured by spectral-domain optical coherence tomography (RTVue-100; Optovue Inc, Fremont, CA) in patients with normal-tension glaucoma (NTG).


METHODS
Sixty-five healthy subjects and 102 with NTG were enrolled. MIRL thickness provided by a ganglion cell complex (GCC) scan and two RNFL thicknesses measured by the NHM4 (RNFL1) and RNFL 3.45 (RNFL2) modes of the RTVue-100 system were analyzed. The areas under the receiver operating characteristic curves (AUCs) of MIRL and pRNFL thicknesses for discriminating patients with NTG from control subjects were determined. The AUCs were compared between patients with central visual field (VF) defects (VF; <or=10 degrees of fixation) and peripheral VF defects (>10 degrees from fixation).


RESULTS
The average MIRL thickness showed a strong correlation with both RNFL1 and -2 thicknesses (R(2) = 0.773, 0.774, both P < 0.0001). The AUCs for average MIRL, RNFL1, and RNFL2 thicknesses were not significantly different at 0.945, 0.973, and 0.976, respectively. However, the AUCs of the average and superior MIRL thicknesses were significantly less than that of the pRNFL thickness in eyes with moderate-to-advanced glaucoma and eyes with peripheral VF defects.


CONCLUSIONS
The average MIRL thickness showed a strong correlation with pRNFL thickness, because patients with NTG at an early stage showed paracentral VF defects near the fixation point. MIRL thickness showed glaucoma discrimination ability comparable to that of pRNFL thickness in patients with NTG with early VF defects. In eyes with advanced or peripheral VF defect, pRNFL measurement showed a better glaucoma diagnostic ability than did MIRL measurement.
Seong
Mincheol
M
Department of Ophthalmology, Hanyang University College of Medicine, Guri Hospital, Gyeonggi-do, Korea.
Sung
Kyung Rim
KR
Choi
Eun Hee
EH
Kang
Sung Yong
SY
Cho
Jung Woo
JW
Um
Tae Woong
TW
Kim
Yoon Jeon
YJ
Park
Seong Bae
SB
Hong
Hun Eui
HE
Kook
Michael S
MS
D019540:Area Under Curve; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D057066:Low Tension Glaucoma / Q000175:diagnosis*; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular