New Normative Database of Inner Macular Layer Thickness Measured by Spectralis OCT Used as Reference Standard for Glaucoma Detection



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Nieves Moreno, María and Martínez de la Casa, Jose Maria and Bambó Rubio, Maria Pilar and Morales Fernández, Laura and Van Keer, Karel and Vandewalle, Evelien and Stalmans, Ingeborg and García Feijoo, Julián (2018) New Normative Database of Inner Macular Layer Thickness Measured by Spectralis OCT Used as Reference Standard for Glaucoma Detection. Translational vision science & technology, 7 (1). ISSN 2164-2591

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Purpose: This study examines the capacity to detect glaucoma of inner macular layer thickness measured by spectral-domain optical coherence tomography (SD-OCT) using a new normative database as the reference standard.
Methods: Participants (N = 148) were recruited from Leuven (Belgium) and Zaragoza (Spain): 74 patients with early/moderate glaucoma and 74 age-matched healthy controls. One eye was randomly selected for a macular scan using the Spectralis SD-OCT. The variables measured with the instrument's segmentation software were: macular nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) volume and thickness along with circumpapillary RNFL thickness (cpRNFL). The new normative database of macular variables was used to define the cutoff of normality as the fifth percentile by age group. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of each macular measurement and of cpRNFL were used to distinguish between patients and controls.
Results: Overall sensitivity and specificity to detect early-moderate glaucoma were 42.2% and 88.9% for mRNFL, 42.4% and 95.6% for GCL, 42.2% and 94.5% for IPL, and 53% and 94.6% for RNFL, respectively. The best macular variable to discriminate between the two groups of subjects was outer temporal GCL thickness as indicated by an AUROC of 0.903. This variable performed similarly to mean cpRNFL thickness (AUROC = 0.845; P = 0.29).
Conclusions: Using our normative database as reference, the diagnostic power of inner macular layer thickness proved comparable to that of peripapillary RNFL thickness.
Translational Relevance: Spectralis SD-OCT, cpRNFL thickness, and individual macular inner layer thicknesses show comparable diagnostic capacity for glaucoma and RNFL, GCL, and IPL thickness may be useful as an alternative diagnostic test when the measure of cpRNFL shows artifacts.

Item Type:Article
Uncontrolled Keywords:Macular layer thickness; Spectralis OCT; OCT; Tomography; Glaucoma; glaucoma detection; Inner macular layer thickness
Subjects:Medical sciences > Medicine > Diagnostic imaging and Nuclear medicine
Medical sciences > Medicine > Ophtalmology
ID Code:47056
Deposited On:06 Apr 2018 08:03
Last Modified:06 Apr 2018 08:03

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