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Diagnostic criteria for detection of retinal nerve fibre layer thickness and neuroretinal rim width abnormalities in glaucoma
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  • Published on: 20 June 2019
    Reliability of Bruch’s membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT)
    • Isha Agarwalla, Ophthalmologist Sri Sankaradeva Netralaya
    • Other Contributors:
      • Prafulla Sarma, Ophthalmologist
      • Shahinur Tayab, Ophthalmologist
      • Chengchira Sangma, Ophthalmologist
      • Mayuri Borgohain, Ophthalmologist
      • Suklengmung Buragohain, Ophthalmologist
      • Sushmita Paul, Ophthalmologist

    Dear Editor,
    With great interest, we have read the article by Feihui et al.[1]
    This study has investigated the sensitivities and specificities of different diagnostic criteria based on the OCT for glaucoma detection. According to the article abnormal superotemporal and inferotemporal RNFLT attained a higher sensitivity than abnormal superotemporal and inferotemporal BMO-MRW to detect mild glaucoma. However, our query arises when “Integration of RNFLT / BMO-MRW assessment was done”. The author stated, integrating RNFLT and BMO-MRW assessment did not change the sensitivity and specificity of RNFLT but increased the sensitivity of BMO-MRW for detection of glaucoma. To quote the author, the author paradoxically stated “ Our finding underscores the importance of RNFL imaging and measurement in the diagnostic evaluation of glaucoma”. We are interested to know if sensitivity and specificity on combination is increased, why would the diagonostic performance not increased? Reis et al stated, Bruch's membrane opening minimum rim width (BMO‐MRW) reproducibility were comparable and excellent in both healthy subjects and patients with glaucoma to that of RNFLT measurements.[2]
    The article also did not include head tilt in the confounding covariates, as it was previously stated, head tilt significantly affects OCT image orientation as measured by the FoBMO angle.[3]
    The article has also not mentioned dimensions of the optic nerve head (ONH) as stated previo...

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    Conflict of Interest:
    None declared.