Laura Morales-Fernandez1, Maria Jimenez-Santos2, Jose M Martinez-de-la-Casa3, Ruben Sanchez-Jean3, Maria Nieves2, Federico Saenz-Frances2, Sofia Garcia-Saenz2, Lucia Perucho2, Rosario Gomez-de-Liaño2, Julian Garcia-Feijoo3,4,5. 1. Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain. lauramoralesfernandez@gmail.com. 2. Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain. 3. Ophthalmology Unit, Hospital Clinico San Carlos, Deptartment of Ophthalmology and ORL, Faculty of Medicine, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain. 4. Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense de Madrid, Madrid, Spain. 5. Cooperative Research Network on Age-Related Ocular Disease, and Visual and Life Quality, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
PURPOSE: To compare the diagnostic performance of circumpapillary retinal nerve fiber layer (cpRNFL) analysis versus segmented ganglion cell complex analysis both by spectral-domain optical coherence tomography (SD-OCT) in children with primary congenital glaucoma (PCG). METHODS: Participants were 40 children diagnosed with PCG and 60 healthy children. Ophthalmological data collected (for one eye per child) were cup-disc ratio (C/D) and axial length (AL). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). For the cpRNFL measurements conventional S-D OCT software was used and the capacity of each method to discriminate between normal and glaucomatous eyes was compared. RESULTS: Mean age was 11.20 ± 3.94 years for the glaucoma patients and 10.90 ± 2.46 years for controls (p = 0.64). All measurements were reduced (thinner) in the glaucoma group, significantly so for: cpRNFL, GCL, IPL and outer-superior and outer-inferior quadrant mRNFL. According to their areas under the receiver operating characteristics curve (AUC), temporal superior cpRNFL (0.869) and outer superior GCL (0.840), IPL (0.799), and mRNFL (0.767) showed the better diagnostic capacity. No differences were observed in AUCs for the most discriminatory cpRNFL and macular measurements. CONCLUSION: Segmented macular layer analysis shows a good capacity to discriminate between normal and glaucomatous eyes; which is comparable to that of cpRNFL analysis in children with PCG.
PURPOSE: To compare the diagnostic performance of circumpapillary retinal nerve fiber layer (cpRNFL) analysis versus segmented ganglion cell complex analysis both by spectral-domain optical coherence tomography (SD-OCT) in children with primary congenital glaucoma (PCG). METHODS:Participants were 40 children diagnosed with PCG and 60 healthy children. Ophthalmological data collected (for one eye per child) were cup-disc ratio (C/D) and axial length (AL). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). For the cpRNFL measurements conventional S-D OCT software was used and the capacity of each method to discriminate between normal and glaucomatous eyes was compared. RESULTS: Mean age was 11.20 ± 3.94 years for the glaucomapatients and 10.90 ± 2.46 years for controls (p = 0.64). All measurements were reduced (thinner) in the glaucoma group, significantly so for: cpRNFL, GCL, IPL and outer-superior and outer-inferior quadrant mRNFL. According to their areas under the receiver operating characteristics curve (AUC), temporal superior cpRNFL (0.869) and outer superior GCL (0.840), IPL (0.799), and mRNFL (0.767) showed the better diagnostic capacity. No differences were observed in AUCs for the most discriminatory cpRNFL and macular measurements. CONCLUSION: Segmented macular layer analysis shows a good capacity to discriminate between normal and glaucomatous eyes; which is comparable to that of cpRNFL analysis in children with PCG.
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