Diagnostic Ability of Retinal Nerve Fiber Layer Thickness Deviation Map for Localized and Diffuse Retinal Nerve Fiber Layer Defects.
Purpose. To evaluate the diagnostic ability of the retinal nerve fiber layer (RNFL) deviation map for glaucoma with localized or diffuse RNFL defects.Methods. Eyes of 139 glaucoma patients and 165 healthy subjects were enrolled. All participants were imaged with Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA). A RNFL defect was defined as at least 10 contiguous red (<1% level) superpixels in RNFL deviation map. The area, location, and angular width of RNFL defects were automatically measured. We compared sensitivities, specificities, and area under the receiver operating characteristic curves (AUCs) of RNFL deviation map and circumpapillary RNFL thickness for localized and diffuse RNFL defects. Subgroup analysis was performed according to the severity of glaucoma.Results. For localized defects, the area of RNFL defects (AUC, 0.991; sensitivity, 97%; specificity, 90%) in deviation map showed a higher diagnostic performance (p= 0.002) than the best circumpapillary RNFL parameter (inferior RNFL thickness; AUC, 0.914; sensitivity, 79%; specificity, 92%). For diffuse defects, there was no significant difference between the RNFL deviation map and circumpapillary RNFL parameters. In mild glaucoma with localized defect, RNFL deviation map showed a better diagnostic performance than circumpapillary RNFL measurement.Conclusions. RNFL deviation map is a useful tool for evaluating glaucoma regardless of localized or diffuse defect type and has advantages over circumpapillary RNFL measurement for detecting localized RNFL defects.
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
Joong Won
JW
Shin
Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
Mincheol
M
Seong
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Jung Wook
JW
Lee
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Eun Hee
EH
Hong
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Ki Bang
0000-0002-7649-3695
KB
Uhm