Elsevier

Ophthalmology

Volume 110, Issue 1, January 2003, Pages 177-189
Ophthalmology

Regular article
Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes

Presented in part at the American Academy of Ophthalmology (AAO), Orlando, Florida, 1999.
https://doi.org/10.1016/S0161-6420(02)01564-6Get rights and content

Abstract

Purpose

To evaluate the hypothesis that macular thickness correlates with the diagnosis of glaucoma.

Design

Cross-sectional study.

Participants

We studied 367 subjects (534 eyes), including 166 eyes of 109 normal subjects, 83 eyes of 58 glaucoma suspects, 196 eyes of 132 early glaucoma patients, and 89 eyes of 68 advanced glaucoma patients.

Methods

We used optical coherence tomography (OCT) to measure macular and nerve fiber layer (NFL) thickness and to analyze their correlation with each other and with glaucoma status. We used both the commercial and prototype OCT units and evaluated correspondence between measurements performed on the same eyes on the same days.

Main outcome measure

Macular and NFL thickness as measured by OCT.

Results

All NFL parameters both in prototype and commercial OCT units were statistically significantly different comparing normal subjects and either early or advanced glaucoma (P < 0.001). Inner ring, outer ring, and mean macular thickness both in prototype and commercial OCT devices were found to be significantly different between normal subjects and advanced glaucomatous eyes (P < 0.001). The outer ring was the only macular parameter that could significantly differentiate between normal and early glaucoma with either the prototype or commercial OCT unit (P = 0.003, P = 0.008, respectively). The area under the receiver operator characteristic (AROC) curves comparing mean NFL thickness between normal and advanced glaucomatous eyes was 1.00 for both the prototype and commercial OCT devices for eyes scanned on both machines on the same day. The AROC comparing mean macular thickness in normal and advanced glaucomatous eyes scanned on both machines on the same day was 0.88 for the prototype OCT device and 0.80 for the commercial OCT.

Conclusions

Both macular and NFL thickness as measured by OCT showed statistically significant correlations with glaucoma, although NFL thickness showed a stronger association than macular thickness. There was good correspondence between findings using both the prototype and commercial OCT units. Macular and NFL thickness measurements made with OCT may have usefulness in the clinical assessment of glaucoma.

Section snippets

Materials and methods

A total of 367 subjects (534 eyes) examined between October 1998 and July 2000 at the New England Eye Center, Boston, Massachusetts, were enrolled in this cross-sectional study after informed consent approved by the New England Medical Center Human Investigation Review Committee.

All subjects underwent a thorough ophthalmologic examination. This consisted of the following: medical history (including ocular and family histories), visual acuity, refraction, intraocular pressure (IOP) measurement,

Subject basic characteristics

We performed peripapillary NFL and macula scans using the prototype OCT unit on 534 eyes of 367 subjects. A subset of subjects underwent peripapillary NFL (95 eyes of 61 subjects) and macular (126 eyes of 81 subjects) scanning with the commercial OCT unit on the same day as their prototype OCT scan. Demographic data are summarized in Table 1.

Effects of age, gender, and race among normal eyes

There was an effect of age on mean macular thickness. When measurements were performed with the prototype OCT unit, for which there was a larger

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  • Cited by (0)

    Joel S. Schuman and Gadi Wollstein shared equal parts in the preparation of the manuscript.

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