title: Diagnostic specificities of retinal nerve fiber layer, optic nerve head, and macular ganglion cell-inner plexiform layer measurements in myopic eyes.
abstract: OBJECTIVE
  To evaluate and compare the diagnostic specificities of peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell-inner plexiform layer (GC-IPL) thickness, and optic nerve head (ONH) measurements in nonglaucomatous myopic individuals.
  
  
  METHODS
  In a prospective, cross-sectional study, participants underwent a complete ophthalmic examination, a screening automated visual field test, and axial length measurement. The study eye then underwent optic nerve head and macular scanning using spectral-domain optical coherence tomography (OCT) instrumentation to determine RNFL thickness, GC-IPL thickness, and ONH measurements. False-positive rates for each of the OCT-derived parameters, using predefined criteria for an abnormal test, were calculated. Comparative analysis was performed using the McNemar test.
  
  
  RESULTS
  Data from 43 eligible subjects were analyzed. The mean age was 30±6.8 years (range, 22 to 50 y) with an average axial length of 25.26±1.21 mm (range, 23.06 to 29.07 mm) and mean spherical equivalent of -4.50±1.93 D (range, -1.00 to -9.00 D). The false-positive rate was higher when using RNFL parameters compared with both ONH (47% vs. 7%, respectively; P<0.001) and GC-IPL (47% vs. 26%, respectively; P=0.049) parameters. The false-positive rate was higher when using GC-IPL parameters, compared with ONH parameters (26% vs. 7%, respectively; P=0.039).
  
  
  CONCLUSIONS
  Caution should be exercised when relying on OCT-derived RNFL and GC-IPL thickness values to diagnose glaucoma in myopic individuals. OCT-derived ONH parameters perform better than RNFL and GC-IPL parameters and may increase diagnostic specificity in this population.
authors.affiliation: Bascom Palmer Eye Institute, Miami Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Aref
authors.forename: Fouad E
authors.initials: FE
authors.lastname: Sayyad
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Mwanza
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: Donald L
authors.initials: DL
authors.lastname: Budenz
mesh_terms: D000328:Adult; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000175:diagnosis* / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D055351:Retinal Neurons / Q000473:pathology*; D041623:Tomography, Optical Coherence; D055815:Young Adult