title: Diagnostic capability of spectral-domain optical coherence tomography for glaucoma.
abstract: OBJECTIVE
  To determine the diagnostic capability of spectral-domain optical coherence tomography in glaucoma patients with visual field defects.
  
  
  METHODS
  Prospective, cross-sectional study.
  
  
  METHODS
  
  
  
  METHODS
  Participants were recruited from a university hospital clinic.
  
  
  METHODS
  One eye of 85 normal subjects and 61 glaucoma patients with average visual field mean deviation of -9.61 ± 8.76 dB was selected randomly for the study. A subgroup of the glaucoma patients with early visual field defects was calculated separately.
  
  
  METHODS
  Spectralis optical coherence tomography (Heidelberg Engineering, Inc) circular scans were performed to obtain peripapillary retinal nerve fiber layer (RNFL) thicknesses. The RNFL diagnostic parameters based on the normative database were used alone or in combination for identifying glaucomatous RNFL thinning.
  
  
  METHODS
  To evaluate diagnostic performance, calculations included areas under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio.
  
  
  RESULTS
  Overall RNFL thickness had the highest area under the receiver operating characteristic curve values: 0.952 for all patients and 0.895 for the early glaucoma subgroup. For all patients, the highest sensitivity (98.4%; 95% confidence interval, 96.3% to 100%) was achieved by using 2 criteria: ≥ 1 RNFL sectors being abnormal at the < 5% level and overall classification of borderline or outside normal limits, with specificities of 88.9% (95% confidence interval, 84.0% to 94.0%) and 87.1% (95% confidence interval, 81.6% to 92.5%), respectively, for these 2 criteria.
  
  
  CONCLUSIONS
  Statistical parameters for evaluating the diagnostic performance of the Spectralis spectral-domain optical coherence tomography were good for early perimetric glaucoma and were excellent for moderately advanced perimetric glaucoma.
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Wu
authors.forename: Johannes F
authors.initials: JF
authors.lastname: de Boer
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis; D058609:Visual Field Tests; D014794:Visual Fields