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Comparison of glaucoma diagnostic ability of retinal nerve fibre layer thickness, ganglionic cell complex thickness and optic disc measurements made with the spectral domain optical coherence tomography

Chandrima Paul

To evaluate the diagnostic accuracy of retinal nerve fibre layer thickness (RNFLT), ganglion cell complex (GCC), and optic disc measurements made with the RTVue-100 Fourier-domain optical coherence tomography (OCT) to detect glaucoma in an Asian population. One randomly selected eye of 532 Asian patients (132 healthy, 112 ocular hypertensive, 134 preperimetric glaucoma, and 154 perimetric glaucoma eyes) was evaluated. Using the softwareprovided classification, the Total population sensitivity for GCC was 82.7% , RNFLT parameters did not exceed 73.6% and for the optic nerve head 62.8. Specificity was high (92.6–100%) for most RNFLT and GCC parameters, but low (74.0–76.4%) for the optic disc parameters. Positive predictive value (PPV) varied between 96.1 and 100% for the main RNFLT parameters, 94.6 and 100% for the 16 RNFLT sectors, 96.4 and 99.0% for the GCC parameters, but did not exceed 86.3% for any of the optic disc parameters. Positive likelihood ratio (PLR) was higher than 10 for average, inferior and superior RNFLT (28.5 to infinite), 12 of the 16 RNFLT sectors (14.6 to infinite), and three of the four GCC parameters (40.0 to 48.6). No optic disc parameter had a PLR higher than 2.0. RNFLT and GCC parameters of the RTVue-100 Fourier-domain OCT showed moderate sensitivity but high specificity, positive predictive value and PLR for detection of glaucoma. The optic disc parameters had lower diagnostic accuracy than the RNFLT and GCC parameters.

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