Dataset Information

Segmental inner macular layer analysis with spectral-domain optical coherence tomography for early detection of normal tension glaucoma.

ABSTRACT:

Purpose

To segment the inner macular layers (IML) and compare the discriminating abilities of the macular and peripapillary retinal nerve fiber layer (mRNFL and pRNFL, respectively) thicknesses in patients with early-stage normal tension glaucoma (NTG).

Design

Cross-sectional study.

Methods

Forty-nine normal subjects and 69 preperimetric glaucoma (PPG) and 60 NTG patients were enrolled. Spectral-domain optical coherence tomography (SD-OCT) was used to obtain pRNFL and macular thickness parameters and segment the IML in all subjects. Area under the receiver operating characteristic (AUROC) curves were used to compare the diagnostic capabilities of different parameters.

Results

The pRNFL, total macular layer (TML), mRNFL, and macular ganglion cell layer (mGCL) were significantly thinner in the NTG group than in the PPG and normal groups. The global and superotemporal pRNFL and the mGCL in the superior outer area were the three best parameters for detecting early NTG. The discriminating capabilities of the superior and inferior mGCL were comparable to those of the corresponding pRNFL (p = 0.573, 0.841). Concerning location, the mGCL had higher AUROCs in the outer sectors (0.863, 0.837) than in the inner sectors (0.747, 0.747). Pearson's correlation coefficients also revealed significant correlations between the mGCL and pRNFL (superior: r = 0.499, inferior: r = 0.624). The strongest correlation was between the mGCL and mean deviation (MD) (superior: r = 0.434 and inferior: r = 0.402).

Conclusions

The diagnostic value of mGCL thickness is comparable to that of pRNFL thickness. IMLs in the outer sectors had better diagnostic capabilities than those in the inner sector for detecting early NTG.

SUBMITTER: Lin JP

PROVIDER: S-EPMC6328176 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Segmental inner macular layer analysis with spectral-domain optical coherence tomography for early detection of normal tension glaucoma.

Lin Jih-Pin JP Lin Pei-Wen PW Lai Ing-Chou IC Tsai Jen-Chia JC

PloS one 20190110 1

<h4>Purpose</h4>To segment the inner macular layers (IML) and compare the discriminating abilities of the macular and peripapillary retinal nerve fiber layer (mRNFL and pRNFL, respectively) thicknesses in patients with early-stage normal tension glaucoma (NTG).<h4>Design</h4>Cross-sectional study.<h4>Methods</h4>Forty-nine normal subjects and 69 preperimetric glaucoma (PPG) and 60 NTG patients were enrolled. Spectral-domain optical coherence tomography (SD-OCT) was used to obtain pRNFL and macul ...[more]

PMID: 30629663

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Project description:Importance:Whether optical coherence tomography angiography (OCT-A) outperforms OCT to detect glaucoma remains inconclusive. Objective:To compare (1) the diagnostic performance for detection of glaucoma and (2) the structure-function association between inner macular vessel density and inner macular thickness. Design, Setting, and Participants:This cross-sectional study included 115 patients with glaucoma and 35 healthy individuals for measurements of retinal thickness and retinal vessel density, segmented between the anterior boundary of internal limiting membrane and the posterior boundary of the inner plexiform layer, over the 3 × 3-mm2 macula using swept-source OCT. All participants were Chinese. Visual sensitivity corresponding to the 3 × 3-mm2 macular region was expressed in unlogged 1/lambert for investigation of the structure-function associations. Diagnostic performance was evaluated with area under the receiver operating characteristic curves (AUCs). The study was conducted between January 12, 2016, and December 12, 2016. Main Outcomes and Measures:Area under the receiver operating characteristic curve and R2 analysis. Results:Of the 115 patients with glaucoma, 42 (36.5%) were women (mean [SD] age, 53.5 [13.4] years); of the 35 individuals with healthy eyes, 25 (71.4%) were women (age, 60.6 [5.9] years). Inner macular vessel density and thickness were 4.3% (95% CI, 2.4%-6.1%) and 21.1 μm (95% CI, 17.4-24.9 μm) smaller, respectively, in eyes with glaucoma compared with healthy eyes. The AUC of mean inner macular thickness for glaucoma detection was greater than that of mean inner macular vessel density (difference, 0.17; 95% CI, 0.01-0.31; P = .03). At 90% specificity, the sensitivity of mean inner macular thicknesses for detection of glaucoma was greater than that of mean inner macular vessel densities (difference, 29.2%; 95% CI, 11.5%-64.6%; P = .02). The strength of the structure-function association was stronger for mean inner macular thickness than mean inner macular vessel density in the linear (difference in R2 = 0.38; 95% CI, 0.22-0.54; P < .001) and nonlinear (difference in R2 = 0.36; 95% CI, 0.21-0.51; P < .001) regression models. Conclusions and Relevance:In this study, OCT measurement of inner macular thickness shows a higher diagnostic performance to detect glaucoma and a stronger structure-function association than the currently used OCT-A measurement of inner macular vessel density. These findings may suggest that OCT-A of the macula has a limited role in the diagnostic evaluation of glaucoma.

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Dataset Information

Segmental inner macular layer analysis with spectral-domain optical coherence tomography for early detection of normal tension glaucoma.

Purpose

Design

Methods

Results

Conclusions

Publications

Segmental inner macular layer analysis with spectral-domain optical coherence tomography for early detection of normal tension glaucoma.

Similar Datasets

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