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Retinal nerve fiber thickness measured with optical coherence tomography (OCT) accurately detects confirmed glaucomatous damage.
  1. Donald Hood (dch3{at}columbia.edu),
  2. Noga Harizman,
  3. Fabio N. Kanadani,
  4. Thomas M. Grippo,
  5. Samuel Baharestani,
  6. Vivienne Greenstein,
  7. Jeffrey M Liebmann (jml18{at}earthlink.net),
  8. Robert Ritch (ritchmd{at}earthlink.net)
  1. Columbia University, United States
  2. New York Eye and Ear Infirmary, United States
  3. New York Eye and Ear Infirmary, United States
  4. New York Eye and Ear Infirmary, United States
  5. New York Eye and Ear Infirmary, United States
  6. New York Eye and Ear Infirmary, United States
  7. New York University School of Medicine, United States
  8. New York Eye and Ear Infirmary, United States

    Abstract

    Aim: To assess the accuracy of optical coherence tomography (OCT) in detecting damage to a hemifield, patients with hemifield defects confirmed on both static automated perimetry (SAP) and multifocal visual evoked potentials (mfVEP) were studied.

    Methods: Eyes of 40 patients with concomitant SAP and mfVEP glaucomatous loss and 25 controls underwent OCT retinal nerve fiber layer (RNFL), mfVEP and 24-2 SAP tests. For the mfVEP and 24-2 SAP, a hemifield was defined as abnormal based upon cluster criteria. On OCT, a hemifield was considered abnormal if one of the 5 clock hour sectors (3 and 9 o'clock excluded) was at < 1% (red) or two were at < 5% (yellow).

    Results: 77 (43%) of the hemifields were abnormal on both mfVEP and SAP tests. The OCT was abnormal for 73 (95%) of these. Only 1 (1%) of the 100 hemifields of the controls was abnormal on OCT. Sensitivity/specificity (one eye per person) was 95/98%.

    Conclusions: The OCT RNFL test accurately detects abnormal hemifields confirmed on both subjective and objective functional tests. Identifying abnormal hemifields with a criterion of 1 red (1%) or 2 yellow (5%) clock hours may prove useful in clinical practice.

    • OCT
    • automated perimetry
    • glaucoma
    • multifocal VEP
    • optical coherence tomography

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