Identifying early glaucoma with optical coherence tomography

Purpoe To evaluate performance of optical coherence tomography (OCT) for detection of early glaucoma. Deign Obervational cae-control tudy. Method Univerity-baed tertiary care center. One eye from 50 normal, 42 glaucoma upect, and 59 early glaucoma patient meeting the following criteria: viual field (VF) mean deviation ≥−6.00 dB, age ≥40 year, pherical refractive error ≤5 diopter, atigmatim ≤3 diopter, and viual acuity ≥20/30. Early glaucoma by VF (EGVF) wa decribed a repeatable abnormal achromatic VF baed on predefined criteria. Glaucoma upect (G) were defined a preence of glaucomatou dik appearance with normal achromatic VF. Average nerve fiber layer thickne (NFLT) and NFLT in each of four quadrant and 12 clock-hour ector. Receiver operating characteritic curve and enitivity and pecificity were ued to ae the performance of OCT. Reult Average NFLT wa 128.4 ± 15.4, 102.0 ± 25.4, and 86.5 ± 31.5 μm in normal, G, and EGVF eye, repectively. Normal eye were different from both glaucoma group (P < .001); NFLT in the uperior quadrant and at the 11 oʹclock poition had the highet area under the receiver operating characteritic curve (.840 and .933) in the G and EGVF group (P = .03). The enitivity of the OCT for detection of glaucoma wa 71% and 85% for the G and EGVF group with pecificity fixed at 90%. Concluion The OCT dicriminate well between eye with early perimetric glaucoma and normal eye. However, it performance i le adequate in eye with upiciou dik and normal VF.