Macular ganglion cell layer imaging in preperimetric glaucoma with speckle noise-reduced spectral domain optical coherence tomography.

To visualize the macular ganglion cell layer (GCL) and measure its thickness in normal eyes and eyes with preperimetric glaucoma, using speckle noise-reduced spectral domain optical coherence tomography (SD-OCT). Retrospective consecutive case series. Thirty-seven eyes of 37 patients with preperimetric glaucoma and 39 normal eyes of 39 volunteers. Vertical and horizontal SD-OCT B-scan images were acquired with minimal speckle noise by using eye-tracking to obtain and average 50 B-scans at each identical location of interest. B-scan images were manually analyzed for GCL, retinal nerve fiber layer (RNFL), and inner plexiform layer shapes and thicknesses in the macula. Macular GCL images and thickness in normal eyes and in eyes with preperimetric glaucoma. The macular GCL was clearly seen on speckle noise-reduced SD-OCT images in normal eyes and eyes with preperimetric glaucoma. In each eye with preperimetric glaucoma, thinning of the macular GCL was visually apparent, particularly on vertical scans. The mean regional macular GCL was most severely thinned in the inferior perifoveal region, where its thickness was <70% of its normal thickness in 30 (81.1%) of the 37 eyes and <50% of its normal thickness in 13 (35.1%) of the 37 eyes. When the sensitivity and specificity for detecting abnormal thinning (outside the lower limit of 99% confidence interval [CI] for the means in the 39 normal eyes) in at least one 0.5-mm segment or sector were compared, the macular GCL on vertical B-scans exhibited higher sensitivity (81.1%) than the other layers on vertical B-scans (99% CI, 5.4%-59.5%; P = 0.00075-0.02100), the macular GCL (99% CI, 40.5%; P = 0.00027) on horizontal B-scans, the other layers (99% CI, 5.4%-48.6%; P<0.00048-0.00400) on horizontal B-scans, and circumpapillary RNFL automatically measured on SD-OCT (54.1%; P = 0.021), and scanning laser polarimetry with variable corneal compensation (24.3%; P = 0.00095). All the macular layers on both the vertical and horizontal B-scans and circumpapillary RNFL thickness exhibited comparable specificity (91.4-100.0%, statistically not different). Speckle noise-reduced SD-OCT imaging allowed clear visualization and measurement of the macular GCL, which was severely thinned in eyes with preperimetric glaucoma. Proprietary or commercial disclosure may be found after the references.

Nakano N ，Hangai M ，Nakanishi H ，Mori S ，Nukada M ，Kotera Y ，Ikeda HO ，Nakamura H ，Nonaka A ，Yoshimura N ... -  《-》

Imaging of localized retinal nerve fiber layer defects in preperimetric glaucoma using spectral-domain optical coherence tomography.

Nukada M ，Hangai M ，Mori S ，Takayama K ，Nakano N ，Morooka S ，Ikeda HO ，Akagi T ，Nonaka A ，Yoshimura N ... -  《-》

Three-dimensional imaging of the macular retinal nerve fiber layer in glaucoma with spectral-domain optical coherence tomography.

Sakamoto A ，Hangai M ，Nukada M ，Nakanishi H ，Mori S ，Kotera Y ，Inoue R ，Yoshimura N ... -  《-》

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 ... -  《-》

Comparison of retinal nerve fiber layer imaging by spectral domain optical coherence tomography and scanning laser ophthalmoscopy.

To compare the area and the angular width of localized retinal nerve fiber layer (RNFL) defects imaged by confocal scanning laser ophthalmoscopy (CSLO) and optical coherence tomography (OCT) and to evaluate their agreement. Cross-sectional study. Fifty-one eyes of 41 glaucoma patients. Sixty-one distinctive, localized RNFL defects (17 superior and 44 inferior RNFL defects) detected in RNFL photographs imaged by a CSLO were identified. These patients underwent RNFL imaging with a spectral-domain OCT. The RNFL thickness deviation maps (50×50 pixels) generated by the OCT revealed the locations of abnormal RNFL thicknesses with abnormal pixels denoted in red (RNFL thickness less than the lower 99% normal distribution) or yellow (RNFL thickness less than the lower 95% normal distribution). The RNFL thickness deviation maps were aligned and overlaid with the corresponding CSLO RNFL photographs. The area and the angular width of RNFL defects from the corresponding retinal regions in the CSLO RNFL photographs and the OCT RNFL thickness maps were measured and compared. Their agreement was analyzed with the Bland-Altman plot. The area and the angular width of RNFL defects and the agreement of RNFL defects measurements between OCT images and CSLO RNFL photographs. The area and the angular width of RNFL defects measured with the CSLO RNFL photographs were 1.11 ± 0.57 mm² and 23.80 ± 10.38°, respectively, which were significantly smaller than those measured by the OCT RNFL thickness deviation map when abnormal RNFL thickness was defined as less than the lower 95% centile ranges (2.27 ± 0.92 mm² and 74.16 ± 28.74°, respectively; both P < 0.001). When abnormal RNFL thickness was defined as less than the lower 99% centile ranges, a significant difference in angular width (42.11 ± 22.19°; P<0.001), but not in area (1.19 ± 0.68 mm²; P = 0.444) was found between the 2 imaging methods. Bland-Altman plots revealed that a larger RNFL defect was associated with a greater difference in angular width between OCT and CSLO RNFL photography measurements. The agreement of RNFL defect measurements between CSLO RNFL photography and OCT was poor. The OCT RNFL thickness deviation map could reveal additional RNFL abnormalities not detectable by CSLO RNFL photography. Proprietary or commercial disclosure may be found after the references.

Ye C ，To E ，Weinreb RN ，Yu M ，Liu S ，Lam DS ，Leung CK ... -  《-》