Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph.

To evaluate and compare the diagnostic agreement and performance for glaucoma detection between a confocal scanning laser ophthalmoscope and a spectral-domain optical coherence tomograph (OCT). Prospective, cross-sectional study. One hundred fifty-five subjects (79 glaucoma and 76 normal subjects). One eye from each individual was selected randomly for optic disc and retinal nerve fiber layer (RNFL) imaging by the Heidelberg Retinal Tomograph (HRT; Heidelberg Engineering, GmbH, Dossenheim, Germany) and the Spectralis OCT (Heidelberg Engineering), respectively. Glaucoma was defined based on the presence of visual field defects with the Humphrey visual field analyzer (Carl Zeiss Meditec, Dublin, CA). The agreement of the categorical classification ("within normal limits," "borderline," and "outside normal limits") at the temporal, superotemporal, superonasal, nasal, inferonasal and inferotemporal sectors of the optic disc were evaluated (kappa statistics). The diagnostic sensitivity and specificity between optic disc and RNFL assessment were compared (McNemar's statistics). Area under the receiver operating characteristic curve (AUC) of OCT RNFL and HRT optic disc parameters were computed after adjustment of age, axial length, and optic disc area. Agreement of categorical classification, AUC of optic disc, and RNFL parameters. The agreement of categorical classification between HRT and Spectralis OCT were fair to moderate (kappa ranged between 0.30 and 0.53) except for global (kappa = 0.63) and inferotemporal (kappa = 0.68) measurements. Defining glaucoma as having "outside normal limits" in the global and/or in >or=1 of the sectoral measurements, the respective sensitivities of Spectralis OCT and HRT were 91.1% and 79.8% (P = 0.012) at a similar level of specificity (97.4% and 94.7%). The AUC of OCT global RNFL thickness (0.978) was greater than those of HRT global rim area (0.905), vertical cup-disc ratio (0.857), rim-disc area ratio (0.897), and multivariate discriminant analysis (0.880-0.925; all with P<or=0.028) after covariates adjustment. The diagnostic classification provided in the HRT and Spectralis OCT analysis report may not agree. At a comparable level of specificity, Spectralis OCT RNFL measurement attained a higher sensitivity than HRT optic disc measurement.

Leung CK ，Ye C ，Weinreb RN ，Cheung CY ，Qiu Q ，Liu S ，Xu G ，Lam DS ... -  《-》

Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: analysis of the retinal nerve fiber layer map for glaucoma detection.

To evaluate the diagnostic performance of the retinal nerve fiber layer (RNFL) thickness deviation map imaged by a spectral-domain optical coherence tomography (OCT; Cirrus HD-OCT, Carl Zeiss Meditec Inc, Dublin, CA) and compare its sensitivity and specificity for glaucoma detection with circumpapillary RNFL measurement derived from the standard 3.46 mm diameter circle scan. Prospective, cross-sectional study. We included 102 normal subjects and 121 glaucoma patients. One eye from each individual was imaged with Cirrus HD-OCT and Stratus OCT (Carl Zeiss Meditec Inc.). Glaucoma was defined based on the presence of visual field defects with the Humphrey visual field analyzer (Carl Zeiss Meditec Inc.). A scoring system (0-5) was developed to analyze the RNFL thickness deviation map taking the defect size, shape, depth, location, and distance from the disc margin into consideration. Each of these features was scored independently by a masked observer with a highest total score of 5 (glaucomatous RNFL defect) and a lowest score of 0 (no RNFL defect). Sensitivity and specificity were computed with a score of > or =3, > or =4, or =5. The diagnostic performance of circumpapillary RNFL measurement was analyzed with clock-hour and average RNFL thickness categorical classification. Diagnostic sensitivity and specificity. The sensitivities of the RNFL thickness deviation map ranged between 95.0% and 97.5%. There were significant differences in specificity between a map score of 5, a map score of > or =4 (87.3%), and a map score > or =3 (72.5%; P< or =0.014). A map score of 5 attained a significantly higher sensitivity (95.0%) compared with clock-hour or average RNFL thickness categorical classification by Stratus OCT or Cirrus HD-OCT (46.3%-88.4%; P< or =0.033) at a comparable level of specificity (95.1%), except when glaucoma was detected as having > or =1 clock-hour at the < or =5% level by Cirrus HD-OCT in which an equally high sensitivity (93.4%) was found but at the expense of a significantly lower specificity (83.3%; P<0.001). Analysis of the RNFL thickness deviation map provides additional spatial and morphologic information of RNFL damage and significantly improves the diagnostic sensitivity for glaucoma detection compared with conventional circumpapillary RNFL measurement.

Leung CK ，Lam S ，Weinreb RN ，Liu S ，Ye C ，Liu L ，He J ，Lai GW ，Li T ，Lam DS ... -  《-》

Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study.

Leung CK ，Cheung CY ，Weinreb RN ，Qiu Q ，Liu S ，Li H ，Xu G ，Fan N ，Huang L ，Pang CP ，Lam DS ... -  《-》

Comparison of retinal nerve fiber layer thickness values using Stratus Optical Coherence Tomography and Heidelberg Retina Tomograph-III.

Moreno-Montañés J ，Antón A ，García N ，Olmo N ，Morilla A ，Fallon M ... -  《-》

Evaluation of optical coherence tomography and heidelberg retinal tomography parameters in detecting early and moderate glaucoma.

Naithani P ，Sihota R ，Sony P ，Dada T ，Gupta V ，Kondal D ，Pandey RM ... -  《INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE》