Ziad Khoueir1, Firas Jassim2, Linda Yi-Chieh Poon3, Edem Tsikata2, Geulah S Ben-David4, Yingna Liu5, Eric Shieh6, Ramon Lee7, Rong Guo8, Georgia Papadogeorgou9, Boy Braaf10, Huseyin Simavli11, Christian Que12, Benjamin J Vakoc10, Brett E Bouma10, Johannes F de Boer13, Teresa C Chen14. 1. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Beirut Eye Specialist Hospital, Beirut, Lebanon. 2. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. 3. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. 4. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Harvard Medical School, Boston, Massachusetts. 6. Harvard Medical School, Boston, Massachusetts; Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California. 7. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, University of Southern California Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California. 8. Department of Medicine, University of California, Los Angeles, California. 9. Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts. 10. Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts. 11. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Pamukkale University School of Medicine, Denizli, Turkey. 12. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines. 13. Department of Physics, LaserLaB Amsterdam, Vrije Universiteit, Amsterdam, Netherlands; Department of Ophthalmology, Vrije Universiteit Medical Center, Amsterdam, Netherlands. 14. Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. Electronic address: Teresa_Chen@meei.harvard.edu.
Abstract
PURPOSE: To determine the diagnostic capability of peripapillary 3-dimensional (3D) retinal nerve fiber layer (RNFL) volume measurements from spectral-domain optical coherence tomography (OCT) volume scans for open-angle glaucoma (OAG). DESIGN: Assessment of diagnostic accuracy. METHODS: Setting: Academic clinical setting. STUDY POPULATION: Total of 180 patients (113 OAG and 67 normal subjects). OBSERVATION PROCEDURES: One eye per subject was included. Peripapillary 3D RNFL volumes were calculated for global, quadrant, and sector regions, using 4 different-size annuli. Peripapillary 2D RNFL thickness circle scans were also obtained. MAIN OUTCOME MEASURES: Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios. RESULTS: Among all 2D and 3D RNFL parameters, best diagnostic capability was associated with inferior quadrant 3D RNFL volume of the smallest annulus (AUROC value 0.977). Otherwise, global 3D RNFL volume AUROC values were comparable to global 2D RNFL thickness AUROC values for all 4 annulus sizes (P values: .0593 to .6866). When comparing the 4 annulus sizes for global RNFL volume, the smallest annulus had the best AUROC values (P values: .0317 to .0380). The smallest-size annulus may have the best diagnostic potential, partly owing to having no areas excluded for being larger than the 6 × 6 mm2 scanned region. CONCLUSION: Peripapillary 3D RNFL volume showed excellent diagnostic performance for detecting glaucoma. Peripapillary 3D RNFL volume parameters have the same or better diagnostic capability compared to peripapillary 2D RNFL thickness measurements, although differences were not statistically significant.
PURPOSE: To determine the diagnostic capability of peripapillary 3-dimensional (3D) retinal nerve fiber layer (RNFL) volume measurements from spectral-domain optical coherence tomography (OCT) volume scans for open-angle glaucoma (OAG). DESIGN: Assessment of diagnostic accuracy. METHODS: Setting: Academic clinical setting. STUDY POPULATION: Total of 180 patients (113 OAG and 67 normal subjects). OBSERVATION PROCEDURES: One eye per subject was included. Peripapillary 3D RNFL volumes were calculated for global, quadrant, and sector regions, using 4 different-size annuli. Peripapillary 2D RNFL thickness circle scans were also obtained. MAIN OUTCOME MEASURES: Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios. RESULTS: Among all 2D and 3D RNFL parameters, best diagnostic capability was associated with inferior quadrant 3D RNFL volume of the smallest annulus (AUROC value 0.977). Otherwise, global 3D RNFL volume AUROC values were comparable to global 2D RNFL thickness AUROC values for all 4 annulus sizes (P values: .0593 to .6866). When comparing the 4 annulus sizes for global RNFL volume, the smallest annulus had the best AUROC values (P values: .0317 to .0380). The smallest-size annulus may have the best diagnostic potential, partly owing to having no areas excluded for being larger than the 6 × 6 mm2 scanned region. CONCLUSION: Peripapillary 3D RNFL volume showed excellent diagnostic performance for detecting glaucoma. Peripapillary 3D RNFL volume parameters have the same or better diagnostic capability compared to peripapillary 2D RNFL thickness measurements, although differences were not statistically significant.
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