title: Central Glaucomatous Damage of the Macula Can Be Overlooked by Conventional OCT Retinal Nerve Fiber Layer Thickness Analyses.
abstract: OBJECTIVE
  To assess the extent to which glaucomatous damage of the macula can be detected using the summary statistics of a commercial report based upon the circumpapillary retinal nerve fiber layer (cpRNFL) thickness obtained with frequency domain optical coherence tomography (fdOCT).
  
  
  METHODS
  One hundred forty-three eyes of 143 open-angle glaucoma patients and suspects (56.4 ± 13.8 years) had 10-2 visual fields (VFs) and fdOCT macular and disc cube scans. RNFL and retinal ganglion cell plus inner plexiform layer thickness and probability maps were generated and combined with 10-2 VF information in a single-page, custom report previously described. Three graders evaluated these reports and classified each eye as "abnormal macula" or "normal macula." Commercially available fdOCT reports for cpRNFL thickness were generated using the automatic segmentation algorithm and norms from the machine. The ability of the reports to detect macular damage was analyzed in three ways: temporal quadrant (TQ) < 5%; TQ < 5% or clock hour 7 < 1% (TQ + CH7); and clock hours 7 through 10 with two sectors < 5% or one sector < 1% (CH7-10).
  
  
  RESULTS
  Sixty-one (43%) eyes were classified "abnormal macula" and 41 (29%) as "normal macula"; the 10-2 VFs and OCT probability maps did not agree in the remaining eyes. Of the 61 abnormal eyes, the TQ criterion missed 47 (77%); TQ + CH7 missed 24 (39%); and CH7-10 missed 22 (36%).
  
  
  CONCLUSIONS
  Conventional cpRNFL analyses on commercial OCT reports can miss macular (central field) damage.
  
  
  CONCLUSIONS
  To detect glaucomatous damage of the macula, additional tests, such as macular cube scans and/or 10-2 VFs, should be performed.
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Wang
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA ; Department of Neurobiology and Behavior, Columbia University, New York, NY, USA.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Raza
authors.affiliation: Department of Ophthalmology, Columbia University, New York, NY, USA.
authors.forename: Carlos Gustavo
authors.initials: CG
authors.lastname: de Moraes
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Chen
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Alhadeff
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
authors.forename: Ravivarn
authors.initials: R
authors.lastname: Jarukatsetphorn
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA ; Department of Ophthalmology, Columbia University, New York, NY, USA.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Hood
keywords: OCT; glaucoma; macula; retinal nerve fiber layer