title: Structural and functional assessment of macula to diagnose glaucoma.
abstract: PurposeTo compare the diagnostic abilities of structural (ganglion cell-inner plexiform layer (GCIPL) thickness measured using spectral domain optical coherence tomography (SDOCT)) and functional (visual sensitivities measured using standard automated perimetry (SAP) and microperimetry (MP)) assessments of macula in glaucoma.MethodsIn a prospective study, 46 control eyes (28 subjects) and 61 glaucoma eyes (46 patients) underwent visual sensitivity estimation at macula (central 10°) by SAP and MP, and GCIPL thickness measurement at macula by SDOCT. Glaucoma was diagnosed by experts based on the optic disc and retinal nerve fiber layer changes. Area under the receiver-operating characteristic (AUC) curves and sensitivities at 95% specificity were used to assess the diagnostic ability of visual sensitivity and GCIPL measurements at various macular sectors.ResultsAUCs of GCIPL parameters ranged between 0.58 and 0.79. AUCs of SAP and MP sensitivities ranged between 0.59 and 0.71, and 0.59 and 0.72, respectively. There were no statistically significant differences between the AUCs of corresponding sector measurements (P>0.10 for all comparisons). Sensitivities at 95% specificities ranged from 31-59% for GCIPL parameters, 16-34% for SAP, and 8-38% for MP parameters. Sensitivities were significantly better with GCIPL compared with SAP and MP parameters in diagnosing glaucoma. Inferotemporal, inferior, and superotemporal sector measurements of GCIPL and visual sensitivity showed the best abilities to diagnose glaucoma.ConclusionsComparing the diagnostic abilities of structural and functional tests at macula in glaucoma, GCIPL thickness measurements with SDOCT performed better than the visual sensitivity measurements by SAP and MP.
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.|Narayana Nethralaya, Rajajinagar, Bangalore, India.
authors.forename: H L
authors.initials: HL
authors.lastname: Rao
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: R S M
authors.initials: RS
authors.lastname: Hussain
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: M
authors.initials: M
authors.lastname: Januwada
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: L N
authors.initials: LN
authors.lastname: Pillutla
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: V U
authors.initials: VU
authors.lastname: Begum
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: A
authors.initials: A
authors.lastname: Chaitanya
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: S
authors.initials: S
authors.lastname: Senthil
authors.affiliation: VST Glaucoma Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: C S
authors.initials: CS
authors.lastname: Garudadri
mesh_terms: D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007194:India; D007429:Intraocular Pressure; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers; D009898:Optic Disk / Q000473:pathology; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests