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Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.

ABSTRACT: To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT).The study included 330 experienced participants in five age-related groups: 77 'preperimetric' open-angle glaucoma (OAG) patients, 52 'early' OAG, 50 'moderate' OAG, 54 ocular hypertensive patients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an 'FDT-score', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%.Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG.Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone.

SUBMITTER: Horn FK

PROVIDER: S-EPMC3144638 | biostudies-literature | 2011 Jan

REPOSITORIES: biostudies-literature

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Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.

Horn F K FK Mardin C Y CY Bendschneider D D Jünemann A G AG Adler W W Tornow R P RP

Eye (London, England) 20101119 1

<h4>Purpose</h4>To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT).<h4>Methods</h4>The study included 330 experienced participants in five age-related groups: 77 'preperimetric' open-angle glaucoma (OAG) patients, 52 'early' OAG, 50 'moderate' OAG, 54 ocular hypertensive patients, and 97 healthy subjects. For glaucoma assessment in all subject ...[more]

PMID: 21102494

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Project description:PurposeTo measure choroidal thickness and to determine parameters associated with it.DesignCross-sectional study.ParticipantsSeventy-four glaucoma patients and glaucoma suspects.MethodsSpectral domain optical coherence tomography (SD-OCT) scans were obtained to estimate average choroidal thickness in a group of glaucoma suspects and glaucoma patients. The average thickness was calculated from enhanced depth SD-OCT images and manually analyzed with Image J software. Open-angle glaucoma, open-angle glaucoma suspect, primary angle-closure glaucoma, primary angle closure, and primary angle-closure suspect were defined by published criteria. Glaucoma suspects had normal visual fields bilaterally. Glaucoma was defined by specific criteria for optic disc damage and visual field loss in ?1 eye. The most affected eye was analyzed for comparisons across individuals, and right/left and upper half/lower half comparisons were made to compare thickness against degree of visual field damage.Main outcome measuresAverage macular and peripapillary choroidal thickness measured using SD-OCT.ResultsThe choroidal-scleral interface was visualized in 86% and 96% of the macular and peripapillary scans, respectively. In multivariable linear regression analysis, the macular choroid was significantly thinner in association with 4 features: Longer eyes (22 ?m per mm longer [95% confidence interval (CI), -33, -11]), older individuals (31 ?m thinner per decade older [95% CI, -44, -17]), lower diastolic ocular perfusion pressure (26 ?m thinner per 10 mmHg lower [95% CI, 8, 44]), and thicker central corneas (6 ?m per 10 ?m thicker cornea [95% CI, -10, 0]). The choroid was not significantly thinner in glaucoma patients than in suspects (14 ?m [95% CI, -54, 26]; P = 0.5). Peripapillary choroidal thickness was not significantly different between glaucoma and suspect patients. Thickness was not associated with damage severity as estimated by visual field mean deviation or nerve fiber layer thickness, including comparisons of right with left eye or upper with lower values.ConclusionsAge, axial length, CCT, and diastolic ocular perfusion pressure are significantly associated with choroidal thickness in glaucoma suspects and glaucoma patients. Degree of glaucoma damage was not consistently associated with choroidal thickness.Financial disclosure(s)Proprietary or commercial disclosure may be found after the references.

Dataset Information

Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.

Publications

Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.

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