Diagnostic precision of retinal nerve fiber layer and macular thickness asymmetry parameters for identifying early primary open-angle glaucoma.

Purpose: To evaluate the diagnostic capabilities of intereye and intraeye differences in retinal nerve fiber layer (RNFL) thickness and macular thickness for identifying early primary open-angle glaucoma (POAG).Design: Prospective, cross-sectional cohort study.Methods: All subjects were enrolled fro...

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Publicado en:American Journal of Ophthalmology Vol. 156; no. 3; pp. 567 - 568
Autores principales: Sullivan-Mee, Michael, Ruegg, Claudia C, Pensyl, Denise, Halverson, Kathy, Qualls, Clifford
Formato: research Journal Article
Publicado: Elsevier B.V. Sep2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2013
      vid: 156
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      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        10.1016/j.ajo.2013.04.037
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        104212293
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        atl: Diagnostic precision of retinal nerve fiber layer and macular thickness asymmetry parameters for identifying early primary open-angle glaucoma.
      aug:
        au:
          Sullivan-Mee, Michael
          Ruegg, Claudia C
          Pensyl, Denise
          Halverson, Kathy
          Qualls, Clifford
        affil: New Mexico Veterans Administration Health Care System, Albuquerque, New Mexico. Electronic address: Michael.Sullivan-Mee@va.gov.
      sug:
        subj:
          Glaucoma Diagnosis
          Retina Pathology
          Nerve Fibers Pathology
          Optic Nerve Pathology
          Optic Nerve Diseases Diagnosis
          Aged
          Cross Sectional Studies
          Female
          Human
          Intraocular Pressure
          Male
          Prospective Studies
          ROC Curve
          Reproducibility of Results
          Sensitivity and Specificity
          Tomography
          Vision Disorders Diagnosis
          Perimetry
          Visual Fields
          Aged: 65+ years
          Female
          Male
      ab: Purpose: To evaluate the diagnostic capabilities of intereye and intraeye differences in retinal nerve fiber layer (RNFL) thickness and macular thickness for identifying early primary open-angle glaucoma (POAG).Design: Prospective, cross-sectional cohort study.Methods: All subjects were enrolled from an ongoing institutional glaucoma study. We used spectral-domain optical coherence tomography (Spectralis; Heidelberg Engineering) to obtain macular thickness (posterior pole asymmetry scan) and RNFL thickness (circumpapillary scan) in both eyes of 50 early POAG and 50 control subjects. Early POAG subjects had glaucomatous optic neuropathy with mild, reproducible visual field loss in at least 1 eye, and control subjects had normal intraocular pressures, visual fields, and optic nerves. We recorded total, superior, and inferior RNFL and macular thicknesses and then calculated intereye and intraeye differences (asymmetry parameters). Statistical evaluation included receiver operating characteristic and multivariate logistic regression analyses.Results: Intereye macular thickness asymmetry had the highest diagnostic sensitivity (88% at 80% specificity; 83% at 95% specificity), followed by total RNFL thickness (88% at 80% specificity; 75% at 95% specificity). Parameters with the largest areas under the receiver operating characteristic curves were: total RNFL thickness (0.937), intereye RNFL asymmetry (0.921), intereye macular thickness asymmetry (0.913), inferior RNFL thickness (0.905), superior RNFL thickness (0.887), intereye inferior macular thickness asymmetry (0.872), and intraeye macular thickness asymmetry (0.860). These 7 values were not significantly different. In multivariate logistic regression analyses, intraeye macular thickness asymmetry, intereye macular thickness asymmetry, intereye RNFL thickness asymmetry, and total RNFL thickness were related independently to early POAG.Conclusions: Structural asymmetry parameters performed well, identifying early POAG as well as RNFL thickness. Further study is indicated to validate these results.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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