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A Diagnostic Calculator for Detecting Glaucoma on the Basis of Retinal Nerve Fiber Layer, Optic Disc, and Retinal Ganglion Cell Analysis by Optical Coherence Tomography

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Larrosa Povés, José Manuel and Moreno Montañes, Javier and Martinez de la Casa, Jose Maria and Polo Llorens, Vicente and Velázquez Villoria, Álvaro and Berrozpe Villabona, Clara and García Granero, Marta (2015) A Diagnostic Calculator for Detecting Glaucoma on the Basis of Retinal Nerve Fiber Layer, Optic Disc, and Retinal Ganglion Cell Analysis by Optical Coherence Tomography. Investigative Ophthalmology & Visual Science, 56 (11). pp. 6788-6795. ISSN 0146-0404

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Official URL: http://dx.doi.org/10.1167/iovs.15-17176



Abstract

Purpose: The purpose of this study was to develop and validate a multivariate predictive model to detect glaucoma by using a combination of retinal nerve fiber layer (RNFL), retinal ganglion cell-inner plexiform (GCIPL), and optic disc parameters measured using spectral-domain optical coherence tomography (OCT).
Methods: Five hundred eyes from 500 participants and 187 eyes of another 187 participants were included in the study and validation groups, respectively. Patients with glaucoma were classified in five groups based on visual field damage. Sensitivity and specificity of all glaucoma OCT parameters were analyzed. Receiver operating characteristic curves (ROC) and areas under the ROC (AUC) were compared. Three predictive multivariate models (quantitative, qualitative, and combined) that used a combination of the best OCT parameters were constructed. A diagnostic calculator was created using the combined multivariate model.
Results: The best AUC parameters were: inferior RNFL, average RNFL, vertical cup/disc ratio, minimal GCIPL, and inferior-temporal GCIPL. Comparisons among the parameters did not show that the GCIPL parameters were better than those of the RNFL in early and advanced glaucoma. The highest AUC was in the combined predictive model (0.937; 95% confidence interval, 0.911–0.957) and was significantly (P = 0.0001) higher than the other isolated parameters considered in early and advanced glaucoma. The validation group displayed similar results to those of the study group.
Conclusions: Best GCIPL, RNFL, and optic disc parameters showed a similar ability to detect glaucoma. The combined predictive formula improved the glaucoma detection compared to the best isolated parameters evaluated. The diagnostic calculator obtained good classification from participants in both the study and validation groups.


Item Type:Article
Uncontrolled Keywords:Glaucoma diagnosis; OCT; Optic disc; Retinal ganglion cell; Retinal nerve fiber layer
Subjects:Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Imaging systems
ID Code:40473
Deposited On:05 Dec 2016 10:45
Last Modified:05 Dec 2016 10:45

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