Original Paper

Retinal Nerve Fiber Layer Evaluation in Open-Angle Glaucoma
Optimum Criteria for Optical Coherence Tomography
Vicente Polo, Jose M. Larrosa, Antonio Ferreras, Francesca Mayoral, Victoria Pueyo, Francisco M. Honrubia

Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain

Address of Corresponding Author

Ophthalmologica 2009;223:2-6 (DOI: 10.1159/000161875)

  Key Words

• Glaucoma, diagnosis
• Optical coherence tomography
• Retinal nerve fiber layer

  Abstract

Purpose: To determine the optimum criteria for optical coherence tomography (OCT) to discriminate best between healthy and glaucomatous eyes. Design: A prospective cross-sectional study. Methods: In total, 164 eyes selected from clinical practice were included in this study. These were classified into 98 healthy and 66 glaucomatous eyes, depending on the intraocular pressure, appearance of the optic disc and standard automated perimetry results. Only 1 eye per subject was randomly included. The retinal nerve fiber layer (RNFL) was evaluated by means of OCT (Stratus OCT 3000). The sensitivity and specificity values of different diagnostic criteria (4 abnormal quadrants and 1–5 abnormal clock-hours) were calculated with different probability levels (p < 0.05 and p < 0.01). Results: The criterion with the best sensitivity-specificity balance was the presence of ≥2 hour positions with an RNFL thickness outside of the 95% confidence interval (CI; sensitivity = 77.2%, specificity = 91.9%). For the 99% CI, the best criterion was the presence of at least 1 abnormal hour position (sensitivity = 71.2%, specificity = 91%). Regarding retinal quadrants, the presence of at least 1 quadrant with RNFL thickness outside of the CI was the criterion that best discriminated the existence of glaucomatous damage. Conclusions: The definition of diagnostic criteria based on OCT structural parameters may improve its diagnostic ability. The highest diagnostic ability was provided by the presence of at least 2 hour positions or RNFL average thickness outside the 95% CI.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Vicente Polo
Oftalmología (Miguel Servet University Hospital)
Isabel la Católica 1–3
ES–50009 Zaragoza (Spain)
Tel. +34 976 765 558, Fax +34 976 566 234, E-Mail vicpolo@telefonica.net

  Article Information

Received: November 6, 2006
Accepted after revision: June 8, 2007
Published online: October 13, 2008
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 4, Number of References : 17