Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage

Wollstein, Gadi; Ishikawa, Hiroshi; Wang, Jiping; Beaton, Siobahn A.; Schuman, Joel S.

doi:10.1016/j.ajo.2004.08.036

« Previous Next »American Journal of Ophthalmology
Volume 139, Issue 1 , Pages 39-43, January 2005

Comparison of three optical coherence tomography scanning areas for detection of glaucomatous damage

Presented in part at the American Academy of Ophthalmology annual meeting, Anaheim, California, November 2003.

Gadi Wollstein, MD
- UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Hiroshi Ishikawa, MD
- UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Jiping Wang, MD, PhD
- Department of Biostatistics, GSPH, University of Pittsburgh, Pittsburgh, Pennsylvania.
Siobahn A. Beaton, BA
- UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Joel S. Schuman, MD
- UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
- Inquiries to Joel S. Schuman, MD, UPMC, Eye Center, University of Pittsburgh School of Medicine, 203 Lothrop Street, The Eye and Ear Institute, Suite 816, Pittsburgh, PA 15213; fax (412) 647-5119

Accepted 17 August 2004. published online 25 November 2004.

Purpose

Several cross-sectional studies have demonstrated the capability of optical coherence tomography (OCT) to detect glaucomatous changes. OCT enables posterior pole scanning of three regions: macula, peripapillary, and optic nerve head (ONH). This study compared the ability of each region to detect glaucomatous damage.

Design

Retrospective observational cross-sectional study.

Methods

The study included 37 normal (37 subjects) and 37 glaucomatous eyes (26 subjects) that had comprehensive ocular examination, reliable and reproducible Swedish interactive thresholding algorithm standard 24–2 perimetry, and Stratus OCT scanning of macula, peripapillary, and ONH regions on the same visit. Optical nerve head (ONH) appearance did not form part of the inclusion criteria. The main outcome measure, was area under receiver operating characteristic curves (AROCs) that was calculated for each scanning region for distinguishing between normal and glaucomatous eyes.

Results

The highest AROCs for distinguishing between groups were for ONH parameters (rim area = 0.97, horizontal integrated rim width = 0.96, vertical integrated rim area = 0.95) and peripapillary nerve fiber layer (NFL) thickness (0.94) followed by macular volume and thickness (both 0.80). A statistically significant difference existed in ONH and NFL AROCs when compared with macular AROCs (P ≤ .007, for both)

Conclusions

OCT ONH and NFL parameters provided similar discrimination capabilities between healthy eyes and those of glaucoma patients and superior discrimination capabilities when compared with macular parameters.