Abstract
Purpose To determine the diagnostic capability of peripapillary 3-dimensional (3D) retinal nerve fiber layer (RNFL) volume measurements from spectral-domain optical coherence tomography (OCT) volume scans for open-angle glaucoma (OAG). Design Assessment of diagnostic accuracy. Methods SETTING: Academic clinical setting. STUDY POPULATION: Total of 180 patients (113 OAG and 67 normal subjects). OBSERVATION PROCEDURES: One eye per subject was included. Peripapillary 3D RNFL volumes were calculated for global, quadrant, and sector regions, using 4 different-size annuli. Peripapillary 2D RNFL thickness circle scans were also obtained. MAIN OUTCOME MEASURES: Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios. Results Among all 2D and 3D RNFL parameters, best diagnostic capability was associated with inferior quadrant 3D RNFL volume of the smallest annulus (AUROC value 0.977). Otherwise, global 3D RNFL volume AUROC values were comparable to global 2D RNFL thickness AUROC values for all 4 annulus sizes (P values:.0593 to.6866). When comparing the 4 annulus sizes for global RNFL volume, the smallest annulus had the best AUROC values (P values:.0317 to.0380). The smallest-size annulus may have the best diagnostic potential, partly owing to having no areas excluded for being larger than the 6 × 6 mm2 scanned region. Conclusion Peripapillary 3D RNFL volume showed excellent diagnostic performance for detecting glaucoma. Peripapillary 3D RNFL volume parameters have the same or better diagnostic capability compared to peripapillary 2D RNFL thickness measurements, although differences were not statistically significant.
| Original language | English |
|---|---|
| Pages (from-to) | 180-193 |
| Number of pages | 14 |
| Journal | American Journal of Ophthalmology |
| Volume | 182 |
| Early online date | 12 Aug 2017 |
| DOIs | |
| Publication status | Published - Oct 2017 |
Funding
Funding/Support: Teresa C. Chen has received funding from the National Institutes of Health UL1 RR 025758 , Massachusetts Lions Eye Research Fund (New Bedford, Massachusetts), American Glaucoma Society Mid-Career Award (San Fransisco, California), and Fidelity Charitable Fund (Harvard University). Boy Braaf, Benjamin J. Vakoc, and Brett E. Bouma received funding from the Center for Biomedical OCT Research and Translation through grant number P41EB015903 , awarded by the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health (Bethesda, Maryland). Financial Disclosures: Benjamin J. Vakoc: licenses to Terumo Corporation (Tokyo, Japan) and Ninepoint Medical (Bedford, Massachusetts). Brett E. Bouma: licenses to NIDEK, Inc (Fremont, California), Terumo Corporation, Ninepoint Medical, and Heidelberg Engineering (Heidelberg, Germany). Johannes F. de Boer: Center for Biomedical Optical Coherence Tomography Research and Translation Scientific Advisory Board Chair (Harvard Medical School), licenses to NIDEK, Inc, Terumo Corporation, Ninepoint Medical, and Heidelberg Engineering. The following authors have no financial disclosures: Ziad Khoueir, Firas Jassim, Linda Yi-Chieh Poon, Edem Tsikata, Geulah S. Ben-David, Yingna Liu, Eric Shieh, Ramon Lee, Rong Guo, Georgia Papadogeorgou, Boy Braaf, Huseyin Simavli, Christian Que, and Teresa C. Chen. All authors attest that they meet the current ICMJE criteria for authorship.
| Funders | Funder number |
|---|---|
| Fidelity Charitable Fund | |
| National Institutes of Health | |
| National Institute of Biomedical Imaging and Bioengineering | P41EB015903 |
| National Center for Research Resources | UL1RR025758 |
| Massachusetts Lions Eye Research Fund | |
| American Glaucoma Society |