title: Macular structure parameters as an automated indicator of paracentral scotoma in early glaucoma.
abstract: OBJECTIVE
  To evaluate the predictive ability of macular parameters defined in the significance map created using spectral-domain optical coherence tomography (SD-OCT) for paracentral visual field defects in early glaucoma.
  
  
  METHODS
  Prospective comparative study.
  
  
  METHODS
  We studied 78 early-glaucomatous eyes of 78 patients, who underwent SD-OCT and standard automated perimetry 10-2. Macular layer parameters included the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) + inner plexiform layer (IPL), and RNFL + GCL + IPL. The minimal distance between the area with abnormal (P < 1%) thickness and foveal center was defined as the shortest distance. A wider area of an abnormally thinned (<1%) region, within either an inferior or a superior hemicircle with a diameter of 6 mm centered at the fovea, was defined as the macular abnormal area. A circumpapillary RNFL parameter was defined in its 36 sectors. Areas under the receiver operating characteristic curves (ROCs) were calculated to discriminate between eyes with (n = 39) and without (n = 39) paracentral visual field defects in the central 5 degrees.
  
  
  RESULTS
  Measurement reproducibility was almost perfect in the macular parameters at P < 1% (intraclass correlation, 0.907-0.942). Areas under the ROC were significantly higher (P ≤ 0.01) in the macular parameters (0.870-0.930), including the shortest distance of GCL + IPL/RNFL + GCL + IPL, and the macular abnormal area of RNFL/GCL + IPL/RNFL + GCL + IPL than in the circumpapillary RNFL parameter (0.676). When specificity was fixed at ≥90%, the shortest distance of GCL + IPL (area under the ROC = 0.874) and the macular abnormal area of RNFL (area under the ROC = 0.894) showed sensitivities greater than 50%.
  
  
  CONCLUSIONS
  Macular structural parameters defined on an SD-OCT significance map may be potentially useful predictors of the presence of paracentral scotoma.
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Yugo
authors: Y
authors: Kimura
authors: Masanori
authors: M
authors: Hangai
authors: Akiko
authors: A
authors: Matsumoto
authors: Tadamichi
authors: T
authors: Akagi
authors: Hanako O
authors: HO
authors: Ikeda
authors: Shinji
authors: S
authors: Ohkubo
authors: Kazuhisa
authors: K
authors: Sugiyama
authors: Aiko
authors: A
authors: Iwase
authors: Makoto
authors: M
authors: Araie
authors: Nagahisa
authors: N
authors: Yoshimura
mesh_terms: D019540:Area Under Curve; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012607:Scotoma / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields