Optic Dik and Nerve Fiber Layer Imaging to Detect Glaucoma Original Reearch Article

Purpoe To compare optic dik and retinal nerve fiber layer (RNFL) imaging method to dicriminate eye with early glaucoma from normal eye. Deign Retropective, cro-ectional tudy. Method In a tertiary care academic glaucoma center, 92 eye of 92 ubject (46 with early perimetric open-angle glaucoma and 46 control) were tudied. Diagnotic performance of optical coherence tomography (tratuOCT; Carl Zei Meditec, Dublin, California, UA), canning laer polarimetry (GDx VCC; Laer Diagnotic Technologie, an Diego, California, UA), confocal laer ophthalmocopy (Heidelberg Retinal Tomograph [HRT] III; Heidelberg Engineering GmbH, Heidelberg, Germany), and qualitative aement of tereocopic optic dik photograph were compared. Outcome meaure were area under receiver operator characteritic curve (AUC) and enitivitie at fixed pecificitie. Claification and regreion tree (CART) analyi wa ued to evaluate combination of quantitative parameter. Reult The average (± tandard deviation) viual field mean deviation for glaucomatou eye wa −4.0 ± 2.5 dB (decibel). Parameter with larget AUC (± tandard error) were: average RNFL thickne for tratuOCT (0.96 ± 0.02), nerve fiber indicator for GDx VCC (0.92 ± 0.03), Frederick . Mikelberg (FM) dicriminant function for HRT III (0.91 ± 0.03), and 0.97 ± 0.02 for dik photograph evaluation. At 95% pecificity, enitivity of dik photograph evaluation (90%) wa greater than GDx VCC (P = .05) and HRT III (P = .002) reult, but not ignificantly different than thoe of tratuOCT (P > .05). The combination of tratuOCT average RNFL thickne and HRT III cup-to-dik area with CART produced a enitivity of 91% and pecificity of 96%. Concluion tratuOCT, GDx VCC, and HRT III performed a well a, but not better than, qualitative evaluation of optic dik tereophotograph for detection of early perimetric glaucoma. The combination of tratuOCT average RNFL thickne and HRT III cup-to-dik area ratio provided a high diagnotic preciion.