title: Detection of glaucoma progression by assessment of segmented macular thickness data obtained using spectral domain optical coherence tomography.
abstract: OBJECTIVE
  We evaluated the clinical use of segmented macular layer thickness measurement in terms of glaucoma diagnosis and the ability to detect progression, and to compare such outcomes to those by circumpapillary retinal nerve fiber layer (cRNFLT) and total macular thickness (TMT) measurements.
  
  
  METHODS
  The study included 141 glaucomatous and 61 healthy eyes. All glaucomatous eyes were subjected to at least four spectral domain optical coherence tomography (SD-OCT) examinations (mean follow-up, 2.13 years). Segmented macular layers were the macular nerve fiber layer (NFL), ganglion cell and inner plexiform layer (GCA), and outer retinal layer (ORL; from outer plexiform layer to retinal pigment epithelium). Areas under receiver operating characteristic curves (AUCs) discriminating healthy from glaucomatous eyes were determined in baseline measurements. The sensitivity and specificity of these parameters in terms of glaucoma progression detection were determined, with reference to assessment of optic disc/retinal nerve fiber layer (RNFL) photographs/visual field (VF) deterioration as standard(s).
  
  
  RESULTS
  GCA afforded the best diagnostic performance among three macular layers. The AUC of the GCA thickness (GCAT) was less than that of cRNFLT (0.869 vs. 0.953, P = 0.018), but superior to that of TMT (0.790, P = 0.05). Of the eyes, 38 showed progression during follow-up by standard
  
  
  METHODS
  The sensitivities of TMT, GCAT, and cRNFLT values in terms of detection of progression were 14%, 8%, and 5%, respectively.
  
  
  CONCLUSIONS
  Although baseline cRNFL measurement was optimal in terms of glaucoma diagnosis, the GCAT and TMT showed similar levels of sensitivity in progression detection.
authors.affiliation: Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Na
authors.forename: Kyung Rim
authors.initials: KR
authors.lastname: Sung
authors.forename: Seunghee
authors.initials: S
authors.lastname: Baek
authors.forename: Yoon Jeon
authors.initials: YJ
authors.lastname: Kim
authors.forename: Mary K
authors.initials: MK
authors.lastname: Durbin
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Lee
authors.forename: Hwang Ki
authors.initials: HK
authors.lastname: Kim
authors.forename: Yong Ho
authors.initials: YH
authors.lastname: Sohn
mesh_terms: D016022:Case-Control Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*