title: Diagnostic Performance of a Novel Three-Dimensional Neuroretinal Rim Parameter for Glaucoma Using High-Density Volume Scans.
abstract: To evaluate the diagnostic performance of a 3-dimensional (3D) neuroretinal rim parameter, the minimum distance band (MDB), using optical coherence tomography (OCT) high-density volume scans for open-angle glaucoma.
  
  
  
  Reliability analysis.
  
  
  
  setting: Institutional.
  
  
  
  Total of 163 patients (105 glaucoma and 58 healthy subjects).
  
  
  
  One eye of each patient was included. MDB and retinal nerve fiber layer (RNFL) thickness values were determined for 4 quadrants and 4 sectors using a spectral-domain OCT device.
  
  
  
  Area under the receiver operating characteristic curve (AUROC) values, sensitivities, specificities, and positive and negative predictive values.
  
  
  
  The best AUROC values of 3D MDB thickness for glaucoma and early glaucoma were for the overall globe (0.969, 0.952), followed by the inferior quadrant (0.966, 0.949) and inferior-temporal sector (0.966, 0.944), and then followed by the superior-temporal sector (0.964, 0.932) and superior quadrant (0.962, 0.924). All 3D MDB thickness AUROC values were higher than those of 2D RNFL thickness. Pairwise comparisons showed that the diagnostic performance of the 3D MDB parameter was significantly better than 2D RNFL thickness only for the nasal quadrant and inferior-nasal and superior-nasal sectors (P = .023-.049). Combining 3D MDB with 2D RNFL parameters provided significantly better diagnostic performance (AUROC 0.984) than most single MDB parameters and all single RNFL parameters.
  
  
  
  Compared with the 2D RNFL thickness parameter, the 3D MDB neuroretinal rim thickness parameter had uniformly equal or better diagnostic performance for glaucoma in all regions and was significantly better in the nasal region.
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Eric
authors.initials: E
authors.lastname: Shieh
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Ramon
authors.initials: R
authors.lastname: Lee
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Christian
authors.initials: C
authors.lastname: Que
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Vivek
authors.initials: V
authors.lastname: Srinivasan
authors.affiliation: Department of Biostatistics, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Rong
authors.initials: R
authors.lastname: Guo
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Regina
authors.initials: R
authors.lastname: DeLuna
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Sumir
authors.initials: S
authors.lastname: Pandit
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Simavli
authors.affiliation: New England College of Optometry, Boston, Massachusetts.
authors.forename: Rajini
authors.initials: R
authors.lastname: Seevaratnam
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Edem
authors.initials: E
authors.lastname: Tsikata
authors.affiliation: LaserLaB Amsterdam, Department of Physics and Astronomy, Vrijie Universiteit, Amsterdam, Netherlands; Department of Ophthalmology, Vrije Universiteit Medical Center, Amsterdam, Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: de Boer
authors.affiliation: Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. Electronic address: teresa_chen@meei.harvard.edu.
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Chen
mesh_terms: D000368:Aged; D019540:Area Under Curve; D005189:False Positive Reactions; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D064368:Healthy Volunteers; D006801:Humans; D021621:Imaging, Three-Dimensional; D007429:Intraocular Pressure; 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; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D014065:Tonometry, Ocular