American Journal of Ophthalmology
Volume 137, Issue 2 , Pages 228-235, February 2004

Identifying early glaucoma with optical coherence tomography☆

Presented as a poster at the annual ARVO meeting, May 4–8, 2003, Fort Lauderdale, Florida.

  • Kouros Nouri-Mahdavi, MD

      Affiliations

    • Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
    • ,
  • Douglas Hoffman, BA

      Affiliations

    • Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
    • ,
  • Dana P. Tannenbaum, MD

      Affiliations

    • Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
    • ,
  • Simon K. Law, MD PharmD

      Affiliations

    • Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
    • ,
  • Joseph Caprioli, MD

      Affiliations

    • Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
    • Corresponding Author InformationInquiries to Joseph Caprioli, MD, Glaucoma Division, Jules Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA 90095, USA; fax: (310) 206-7773

Accepted 2 September 2003.

Abstract 

Purpose

To evaluate performance of optical coherence tomography (OCT) for detection of early glaucoma.

Design

Observational case-control study.

Methods

University-based tertiary care center. One eye from 50 normals, 42 glaucoma suspects, and 59 early glaucoma patients meeting the following criteria: visual field (VF) mean deviation ≥−6.00 dB, age ≥40 years, spherical refractive error ≤5 diopters, astigmatism ≤3 diopters, and visual acuity ≥20/30. Early glaucoma by VF (EGVF) was described as repeatable abnormal achromatic VFs based on predefined criteria. Glaucoma suspects (GS) were defined as presence of glaucomatous disk appearance with normal achromatic VFs. Average nerve fiber layer thickness (NFLT) and NFLT in each of four quadrants and 12 clock-hour sectors. Receiver operating characteristic curves and sensitivity and specificity were used to assess the performance of OCT.

Results

Average NFLT was 128.4 ± 15.4, 102.0 ± 25.4, and 86.5 ± 31.5 μm in normal, GS, and EGVF eyes, respectively. Normal eyes were different from both glaucoma groups (P < .001); NFLT in the superior quadrant and at the 11 o'clock position had the highest area under the receiver operating characteristic curve (.840 and .933) in the GS and EGVF groups (P = .03). The sensitivity of the OCT for detection of glaucoma was 71% and 85% for the GS and EGVF groups with specificity fixed at 90%.

Conclusion

The OCT discriminates well between eyes with early perimetric glaucoma and normal eyes. However, its performance is less adequate in eyes with suspicious disk and normal VFs.

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☆ Biosketches and/or additional material at www.ajo.com doi:10.1016/j.ajo.2003.09.004Supported by a grant from “Research to Prevent Blindness” and NIH-ROI EY12738.

PII: S0002-9394(03)01077-8

doi:10.1016/j.ajo.2003.09.004

American Journal of Ophthalmology
Volume 137, Issue 2 , Pages 228-235, February 2004

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