Journal Article

Diagnostic performance and reproducibility of circumpapillary retinal nerve fiber layer thickness measurement in 10-degree sectors in early stage glaucoma

Maeda, Naoyuki, Sugiyama, Kazuhisa, Kishi, Shoji, Araie, Makoto, Tomidokoro, Atsuo, Yoshimura, Nagahisa, Iwase, Aiko, Hirasawa, Hiroyo, Mayama, Chihiro

2015

Overview

Purpose To study the circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in a 10°-wide sector using spectral-domain optical coherence tomography for diagnostic ability in early stage open-angle glaucoma (OAG). Methods cpRNFLT measurements (3.4-mm diameter centered on the disc) were obtained from 89 eyes with early stage OAG (mean deviation, −2.5 ± 1.8 decibels) and 89 age-matched normal eyes. The ability of 180°-, 90°-, 30°-, and 10°-wide cpRNFLT sectors in discriminating early stage OAG eyes was evaluated by calculating the area under the receiver-operating characteristic curves (AUCs) and sensitivity/specificity per diagnostic criteria with varying sector widths, normative data-based cpRNFLT cutoff levels and numbers of abnormal sectors. The intra- and inter-visit reproducibilities of the cpRNFLT 10°-sector measurements were studied in a separate group of eyes with normal and early stage OAG. Results The greatest AUC obtained using the cpRNFLT 10° sector, 0.924 (confidence interval, 0.875–0.958), did not differ significantly from those obtained with the 180°, 90°, and 30° sectors. Only calculations using the 10° sectors had sensitivities and specificities of 0.90 or higher with the best performance of the sensitivity/specificity of 0.92/0.94. These values tended to be better ( P  = 0.070) than with the 30° sectors, 0.85/0.94, which were also selected with several combinations of various cutoff levels and the number of abnormal sectors. The coefficients of variation for the intra- and inter-visit reproducibility of the 10°-sector measurements were 10 % or less in 32 and 24 of the 36 sectors. Conclusion The cpRNFLT 10°-sector measurements showed reasonable reproducibility and identified eyes with early stage OAG with a sensitivity and specificity of 0.92/0.94.

• Publisher: Springer Japan,Springer Nature B.V
• Subject: Adult / Aged / Area Under Curve / Clinical Investigation / Early Diagnosis / Glaucoma / Glaucoma, Open-Angle - diagnosis / Humans / Intraocular Pressure / Medicine / Medicine & Public Health / Middle Aged / Nerve Fibers - pathology / Ophthalmology / Optic Disk - pathology / Reproducibility of Results / Retinal Ganglion Cells - pathology / ROC Curve / Sensitivity and Specificity / Tomography, Optical Coherence