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  • Retinal nerve fibre thickness measured with optical coherence tomography accurately detects confirmed glaucomatous damage

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Clinical science
Extended reports
Retinal nerve fibre thickness measured with optical coherence tomography accurately detects confirmed glaucomatous damage
  1. D C Hood1,2,
  2. N Harizman3,
  3. F N Kanadani3,
  4. T M Grippo3,
  5. S Baharestani3,
  6. V C Greenstein2,4,
  7. J M Liebmann3,4,
  8. R Ritch3
  1. 1Department of Psychology, Columbia University, New York, NY, USA
  2. 2Department of Ophthalmology, Columbia University, New York, NY, USA
  3. 3Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY, USA
  4. 4Department of Ophthalmology, New York University Medical Center, New York, NY, USA
  1. Correspondence to: Dr D C Hood Department of Psychology, 405 Schermerhorn, Columbia University, New York, NY 10027, USA; dch3{at}columbia.edu

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 fibre 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 five clock hour sectors (3 and 9 o’clock excluded) was at <1% (red) or two were at <5% (yellow).

Results: Seventy seven (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.

  • GHT, glaucoma hemifield test
  • HVF, Humphrey visual field
  • mfVEP, multifocal visual evoked potentials
  • OCT, optical coherence tomography
  • PSD, pattern standard deviation
  • RNFL, retinal nerve fibre layer
  • SAP, static automated perimetry

https://doi.org/10.1136/bjo.2006.111252

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    Footnotes

    • Published Online First 14 February 2007

    • Supported by National Eye Institute grants R01-EY-02115 and R01-EY-09076 and by the Steven and Shelley Einhorn Research Fund of the New York Glaucoma Research Institute, New York NY, USA.

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