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Perimetric glaucoma best detected with OCT through average peripapillary RNFL thickness

J Glaucoma. 2011;20(2):87-94.

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The average thickness of the peripapillary retinal nerve fiber layer is the best optical coherence tomography parameter for determining perimetric glaucoma, a study found.

Researchers measured optic disc morphology, peripapillary retinal nerve fiber layer (RNFL) and macular inner retinal layer (IRL) in 220 eyes of 220 patients using Fourier-domain OCT.

The receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic power of each parameter. If the power had specificity of 80% or greater, it was deemed clinically relevant and presented as the partial area under the ROC curve, or the partial AROC, the study said.

Average thickness had the largest AROC (0.919) and partial AROC (0.147) for peripapillary RNFL parameters. Cup-to-disc vertical ratio had the largest AROC (0.854) and partial AROC (0.142) for the optic disc parameters, and inferior hemisphere thickness had the largest AROC (0.871) and partial AROC (0.138) for the macular IRL parameters.

After conducting a stepwise linear discriminant analysis using OCT parameters and demographic factors, the ability to detect perimetric glaucoma was enhanced further, according to the study.

"With the faster imaging capability of the FD-OCT, simultaneous evaluation of disc morphology, [peripapillary] RNFL and [macular] IRL thickness on the OCT can be effective in distinguishing true glaucoma from glaucoma suspicion," the authors said.