scholarly journals Diagnostic accuracy of optical coherence tomography for diagnosing glaucoma: secondary analyses of the GATE study

2017 ◽  
Vol 102 (5) ◽  
pp. 604-610 ◽  
Author(s):  
Gianni Virgili ◽  
Manuele Michelessi ◽  
Jonathan Cook ◽  
Charles Boachie ◽  
Jennifer Burr ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Nerve Fibre Layer ◽  
Diagnostic Study ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Rnfl Thickness ◽  
Characteristics Analysis ◽  
Secondary Analyses ◽  
The Uk ◽  
Inferior Quadrant

Background/AimsTo assess the diagnostic performance of retinal nerve fibre layer (RNFL) data of optical coherence tomography (OCT) for detecting glaucoma.MethodsSecondary analyses of a prospective, multicentre diagnostic study (Glaucoma Automated Tests Evaluation (GATE)) referred to hospital eye services in the UK were conducted. We included data from 899 of 966 participants referred to hospital eye services with suspected glaucoma or ocular hypertension. We used both eyes’ data and logistic regression-based receiver operator characteristics analysis to build a set of models to measure the sensitivity and specificity of the average and inferior quadrant RNFL thickness data of OCT. The reference standard was expert clinician examination including automated perimetry. The main outcome measures were sensitivity at 0.95 specificity and specificity at 0.95 sensitivity and the corresponding RNFL thickness thresholds. We explored the possibility of accuracy improvement by adding measures of within-eye and between-eye variation, scan quality, intraocular pressure (IOP) and age.ResultsGlaucoma was diagnosed in at least one eye in 17% of participants. Areas under the curve were between 0.83 and 0.88. When specificity was fixed at 0.95, the sensitivity was between 0.38 and 0.55, and the highest values were reached with models including the inferior quadrant rather than the average RNFL thickness. Fixing sensitivity at 0.95, the specificity was between 0.36 and 0.58. The addition of age, refractive error, IOP or within-subject variation did not improve the accuracy.ConclusionRNFL thickness data of OCT can be used as a diagnostic test, but accuracy estimates remain moderate even in exploratory multivariable modelling of aiming to improve accuracy.

scholarly journals Retinal nerve fibre layer thickness measurements in childhood glaucoma: the role of scanning laser polarimetry and optical coherence tomography

2021 ◽  
Author(s):  
Mael Lever ◽  
Christian Halfwassen ◽  
Jan Darius Unterlauft ◽  
Nikolaos E. Bechrakis ◽  
Anke Manthey ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Nerve Fibre ◽  
Retinal Nerve Fibre Layer ◽  
Scanning Laser ◽  
Optical Coherence ◽  
Scanning Laser Polarimetry ◽  
Laser Polarimetry ◽  
Nerve Fibre Layer ◽  
Thickness Measurements ◽  
Inferior Quadrant

Abstract Purpose A central diagnostic tool in adult glaucoma is the peripapillary retinal nerve fibre layer (pRNFL) thickness. It can be assessed by scanning laser polarimetry (SLP) or optical coherence tomography (OCT). However, studies investigating the relevance of pRNFL measurements in children are rare. This study aims to compare the glaucoma diagnosing ability of SLP and OCT pRNFL thickness measurements in a paediatric population. Methods This retrospective study included 105 children (glaucoma: 22 (21.0%); healthy glaucoma suspects: 83 (79.0%)) aged 4–18 years, examined with SLP (GDxPro/ECC, Carl Zeiss Meditec) and spectral-domain OCT (SPECTRALIS®, Heidelberg Engineering). The thickness of pRNFL sectors was compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC) and logistic regression results were used to compare the glaucoma discriminative capacity between SLP and OCT measurements. Results Using OCT, pRNFL thickness was decreased in the superior, nasal, and inferior quadrants of glaucoma patients compared to healthy controls (P < 0.001, each). With SLP, such a difference was only observed in the inferior quadrant (P = 0.011). A correlation between glaucoma diagnosis and OCT-measured pRNFL thickness was found in all quadrants (P < 0.001) other than the temporal. With SLP, a correlation was found for the total average thickness (P = 0.037) and inferior quadrant (P = 0.0019). Finally, the AUCs of OCT measurements were markedly higher than those of SLP (e.g., inferior quadrant: OCT 0.83, SLP 0.68). Conclusion pRNFL thickness measurements using both OCT and SLP, correlate notably with the presence of glaucoma. In general, the diagnostic performance of pRNFL thickness measurements seems higher for OCT than for SLP. Thus, pRNFL thickness measurements could provide important information, complementing conventional clinical and functional parameters in the diagnostic process of paediatric glaucoma.

scholarly journals Retinal Damage in Multiple Sclerosis Disease Subtypes Measured by High-Resolution Optical Coherence Tomography

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Timm Oberwahrenbrock ◽  
Sven Schippling ◽  
Marius Ringelstein ◽  
Falko Kaufhold ◽  
Hanna Zimmermann ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Neuritis ◽  
Large Scale ◽  
Retinal Nerve Fibre Layer ◽  
Spectral Domain ◽  
Healthy Controls ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Spectral Domain Oct ◽  
Rnfl Thickness

Background.Optical coherence tomography (OCT) has facilitated characterisation of retinal alterations in MS patients. Only scarce and in part conflicting data exists on different MS subtypes.Objective.To analyse patterns of retinal changes in different subtypes of MS with latest spectral-domain technology.Methods.In a three-centre cross-sectional study 414 MS patients and 94 healthy controls underwent spectral-domain OCT examination.Results.Eyes of MS patients without a previous optic neuritis showed a significant reduction of both retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) compared to healthy controls independent of the MS subtype (P<0.001for all subtypes). RNFL thickness was lower in secondary progressive MS (SPMS) eyes compared to relapsing-remitting MS (RRMS) eyes (P=0.007), and TMV was reduced in SPMS and primary progressive MS (PPMS) eyes compared to RRMS eyes (SPMS:P=0.039, PPMS:P=0.005). Independent of the subtype a more pronounced RNFL thinning and TMV reduction were found in eyes with a previous optic neuritis compared to unaffected eyes.Conclusion.Analysis of this large-scale cross-sectional dataset of MS patients studied with spectral-domain OCT confirmed and allows to generalize previous findings. Furthermore it carves out distinct patterns in different MS subtypes.

scholarly journals Prevalence of Glaucoma among High Myopia

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
O M Abdelfatah ◽  
O A Salem ◽  
A I Elawamry ◽  
Y A Elzanklony
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
High Myopia ◽  
Cross Sectional Study ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rnfl Thickness

Abstract Background Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma. Purpose To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT). Patients and Methods A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients. Results In our study, we depended on the following highly significant parameters in detection of prevalence of glaucoma among high myopic patients: Spherical equivalent median is -12, Vertical cup/disc ratio mean is 0.55, MD median of visual field is – 5.38, PSD mean of visual field is 3.53, GHT is 64.7% outside normal limits, 17.6% border line and 17.6% general reduction of sensitivity and RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value. Conclusion Prevalence of glaucoma among our study group is 42.5% depending on Spherical equivalent median, Vertical cup/disc ratio mean, MD median of visual field, PSD mean of visual field, GHT and RNFL thickness.

Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis

2020 ◽  
pp. bjophthalmol-2019-315715
Author(s):  
Dong Hyun Kang ◽  
Young Hoon Hwang
Keyword(s):  
Optical Coherence Tomography ◽  
Plexiform Layer ◽  
Retinal Nerve Fibre Layer ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Average Thickness ◽  
Test Selection ◽  
Glaucoma Progression ◽  
Rnfl Thickness ◽  
Baseline Test

PurposeTo evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA).MethodsA total of 53 eyes with either RNFL or GCIPL progression determined using OCT-GPA were included. Three different baseline conditions were created by dividing eight serial OCT tests from each eye into three sets. Specifically, these sets presented baseline tests at exams 1–2 (1st set), 2–3 (2nd set) and 3–4 (3rd set), respectively. Agreement on progression detection was defined as the presence of ‘Possible Loss’ or ‘Likely Loss’ in the 2nd or 3rd sets at the same location in the 1st set.ResultsThe proportion of eyes with agreement on progression detection was 47.1%, 20.0% and 31.0% for RNFL ‘thickness map progression’, ‘thickness profiles progression’ and ‘average thickness progression’, respectively. In GCIPL ‘thickness map progression’ and ‘average thickness progression’, 53.8% and 62.8% of eyes showed agreement, respectively. Eyes with disagreement showed a greater change in thickness (slope of change in the 3rd set−1st set) compared to the eyes with agreement (p<0.05), with the exception of RNFL ‘thickness profiles progression’ (p=0.064).ConclusionGlaucoma progression detection by OCT-GPA was affected by baseline test selection, especially in eyes with a greater reduction in progression. GCIPL thickness was less influenced by baseline test selection compared to RNFL thickness.

scholarly journals Peripapillary vessel density measurement of quadrant and clock-hour sectors in primary angle closure glaucoma using optical coherence tomography angiography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongdong Lin ◽  
Shirong Chen ◽  
Mingzhi Zhang
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Angle Closure ◽  
Optical Coherence ◽  
Diagnostic Ability ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Rnfl Thickness ◽  
Inferior Quadrant

Abstract Background The purpose of this study was to investigate diagnostic ability of peripapillary vessel density of primary angle closure glaucoma (PACG) eyes in quadrant and clock-hour sectors by optical coherence tomography angiography (OCTA). Methods This was a cross-sectional study on forty-one PACG patients (41eyes) and twenty-seven healthy subjects (27 eyes). All subjects underwent OCTA (DRI OCT Triton; Topcon Corporation, Tokyo, Japan) and peripapillary retinal nerve fiber layer (RNFL) thickness imaging with swept-source optical coherence tomography (OCT). The peripapillary vessel density of quadrant and clock-hour sectors was quantified by imageJ software. The diagnostic capability of OCTA and OCT parameters was evaluated by the areas under the receiver operating characteristics curves (AUCs). Pearson correlation analysis or Spearman correlation test was used to evaluate the correlation between vessel density parameters and related factors. Results Compared with the control group, the peripapillary vessel density of glaucomatous group was lower to different degrees in the four quadrants and each clock-hour sectors, and vessel density reduced most at 7 o’clock. The difference between the diagnostic ability of peripapillary vessel density and peripapillary RNFL thickness was not statistically significant, except 4 o’clock and inferior quadrant. The inferior quadrant peripapillary vessel density had the best diagnostic value (AUC0.969), followed by the 7 o’clock vessel density (AUC0.964), average vessel density (AUC0.939) and the 7 o’clock RNFL thickness (AUC0.919). The average peripapillary vessel density was correlated with average RNFL and visual field (VF) mean deviation (P < 0.001). Conclusions In PACG, the diagnostic ability of the peripapillary vessel density is equivalent to the peripapillary RNFL thickness. Understanding spatial characteristics of the peripapillary vessel density in PACG may be helpful for clinical diagnosis and monitoring the progress of diseases.

scholarly journals Retinal nerve fibre layer thickness in a healthy Nepalese population by spectral domain optical coherence tomography

2014 ◽  
Vol 6 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Madhu Thapa ◽  
Safal Khanal ◽  
Gulsan B Shrestha ◽  
Ananda K Sharma
Keyword(s):  
Optical Coherence Tomography ◽  
Layer Thickness ◽  
Nerve Fibre ◽  
Retinal Nerve Fibre Layer ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Rnfl Thickness ◽  
The Mean ◽  
Nerve Fibre Layer ◽  
Sd Oct

Objective: To determine the normal values for peripapillary retinal nerve fibre layer thickness (RNFL) measured by spectral domain optical coherence tomography (SD- OCT) in a healthy Nepalese population and to compare the RNFL thicknesses between the genders and among the various age groups.Material and methods: One hundred and fifty six eyes of 156 healthy Nepalese subjects (66 males and 88 females) of various age groups were enrolled in this observational, cross-sectional, hospital-based study. The peripapillary RNFL of the randomly chosen eye of each subject was imaged with a high resolution SD-OCT (Spectralis HRA+OCT, Heidelberg Engineering). The RNFL thickness was measured around the optic nerve head using 16 automatically averaged, consecutive, circular B scans with a 3.4 mm diameter and compared between the genders and among the various age groups.Results: The mean age of the subjects was 38.94 ± 17.00 years (range - 14 to 76 years). The average peripapillary RNFL was found to be 102.64 ± 9.56 μm (95 % CI 97.01 - 101.93). The mean ± SD peripapillary RNFL measurements at the superior, nasal, inferior and temporal sectors in the study population were 129.51 ± 15.09 μm, 76.55 ± 12.02 μm, 134.53 ± 17.19 μm and 70.74 ± 15.53 μm respectively. The average RNFL thickness was 99.47 ± 10.18 μm in the male whereas it was 105.09 ± 8.31 μm in the female participants. The RNFL decreased by 2.26 μm per age per decade.  Conclusion: The Average RNFL thickness is 102.64 ± 9.56 μm in the Nepalese population. Gender and age related variation in the RNFL could serve as a useful guideline in the diagnosis of glaucoma in our population.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11709Nepal J Ophthalmol 2014; 6(12): 131-139 

scholarly journals Applying a New Automated Perimetry Pattern Based on the Stimulus Distribution of the Multifocal ERG to Improve Structure-Function Investigation in Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Lívia M. Brandão ◽  
Matthias Monhart ◽  
Andreas Schötzau ◽  
Anna A. Ledolter ◽  
Anja M. Palmowski-Wolfe
Keyword(s):  
Optical Coherence Tomography ◽  
Structure Function ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Significant Difference ◽  
Retinal Structure ◽  
One Year

Purpose. To validate a new automated perimetry pattern (mf103 pattern) for the investigation of retinal structure-function relationships in glaucoma in comparison to the standard G2 pattern and to relate either field’s performance to optical coherence tomography (OCT). Methods. Automated perimetry data from the mfERG103 pattern were compared with the standard G2 pattern in glaucoma patients (18) and controls (15). The results of both (mean defect (MD) and mean sensitivity (MS)) were compared with optical coherence tomography (OCT): retinal nerve fiber layer (RNFL) thickness, macular thickness (mT), and ganglion cell analysis (GCIPL). Nine patients were followed up after one year. Results. G2 pattern and mf103 pattern did not differ significantly in MD or MS. The mf103 pattern associated significantly with more RNFL sectors in both MD and MS (p<0.01 and p<0.05, resp.). GCIPL thickness was not significantly associated with either SAP protocols. Both protocols remained comparable after one-year follow-up. Conclusions. G2 and mf103 pattern can both differentiate patients from controls with no significant difference in performance. RNFL thickness defects correlated better with mf103 than G2 with POAG. The mfERG-103 perimetry pattern can be used to establish structure-function correlations in glaucoma and may enable a more direct comparison with objective electrophysiological data.

scholarly journals Thinner temporal peripapillary retinal nerve fibre layer in Stargardt disease detected by optical coherence tomography

2020 ◽  
Author(s):  
Michael Reich ◽  
Jan Lübke ◽  
Lutz Joachimsen ◽  
Julia Stifter ◽  
Sebastian Küchlin ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Disc ◽  
Nerve Fibre ◽  
Retinal Nerve Fibre Layer ◽  
Optical Coherence ◽  
Stargardt Disease ◽  
Rnfl Thickness ◽  
Fibre Layer ◽  
Manual Adjustment ◽  
Nerve Fibre Layer

Abstract Purpose To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness measured by spectral domain optical coherence tomography (OCT) in patients with Stargardt disease (STGD). Methods A cross-sectional, monocentric, observational case-control study. Twenty patients (39 eyes) with ABCA4 mutations graded according to the Fishman STGD classification were included. RNFL measurement was performed using Heidelberg Spectralis SD-OCT. RNFL thickness in STGD patients was compared to age-matched data of healthy individuals provided by the device’s manufacturer. A manual readjustment of the optic disc-fovea angle was performed when needed. Results The mean age at first diagnosis of STGD was 22.9 years (range 9 to 50) and 39.1 years (range 18 to 74) at the time of examination. Thirty-nine percent of eyes (15 eyes) needed manual adjustment of the optic disc-fovea angle due to malfixation of the patients during OCT. The temporal quadrant corresponding to the macula showed a RNFL 16% thinner than controls (mean − 12 μm, 95%CI − 9 to −15 μm). However, global RNFL thickness did not differ from controls due to increased RNFL thickness of 12% in the nasal sectors. Duration and stage of STGD were not correlated to thinner RNFL. Conclusion STGD seems to be associated with thinner peripapillary RNFL in the sector of axons projecting to the degenerated macular area. It is yet unclear as to whether this results from anterograde transneuronal degeneration of direct injury to retinal ganglion cells.

The volume of peripapillary vessels within the retinal nerve fibre layer: an optical coherence tomography angiography study of normal subjects

2017 ◽  
Vol 102 (5) ◽  
pp. 611-621 ◽  
Author(s):  
Davide Allegrini ◽  
Giovanni Montesano ◽  
Paolo Fogagnolo ◽  
Alfredo Pece ◽  
Roberta Riva ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Nerve Fibre ◽  
Optical Coherence Tomography Angiography ◽  
Vascular Tissue ◽  
Retinal Nerve Fibre Layer ◽  
Optical Coherence ◽  
Rnfl Thickness ◽  
Fibre Layer ◽  
The Mean ◽  
Nerve Fibre Layer

Background/aimsTo investigate the contribution of vascular volume calculated by optical coherence tomography angiography (OCTA) to the measurement of peripapillary retinal nerve fibre layer (RNFL) thickness.MethodsWe used OCTA scans to build volumetric maps of the RNFL angiograms by thresholding the decorrelation images and summing the number of white pixels along the z-axis at each location. We used these maps to calculate the contribution of the vascular tissue to the RNFL thickness.ResultsWe analysed 51 eyes from 36 subjects. The mean RNFL volume calculated on the peripapillary region was 0.607±0.045 mm3 and the mean vessel volume was 0.217±0.035 mm3, with a mean vessel/total RNFL ratio of 35.627%±3.942%. When evaluated in the peripapillary circular section, the total contribution of the vascular tissue to the global RNFL thickness was 29.071%±3.945%. The superior and inferior sectors showed the highest percentage of vascular tissue within the RNFL circular profile (31.369% and 34.788% respectively).ConclusionsWe found that the vascular contribution to the RNFL thickness is 29.07±3.945%. This is much higher than what has been reported from calculations made on the structural OCT alone (13% reported by Hood et al and 11.3%±1.6% for the Cirrus OCT and 11.8%±1.4% for the Spectralis OCT reported by Patel et al). We conclude that evaluation of the vascular tissue contribution to the RNFL thickness with OCTA might be useful when performing precise quantification of the neuronal tissue.

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