Elsevier

Ophthalmology

Volume 116, Issue 12, December 2009, Pages 2294-2299
Ophthalmology

Original article
Sensitivity and Specificity of Time-Domain versus Spectral-Domain Optical Coherence Tomography in Diagnosing Early to Moderate Glaucoma

https://doi.org/10.1016/j.ophtha.2009.06.012Get rights and content

Purpose

To evaluate the sensitivity and specificity of measurements of retinal nerve fiber layer (RNFL) thickness in early to moderate glaucoma using Stratus time-domain and Cirrus spectral-domain optical coherence tomography (OCT; Carl Zeiss Meditec, Dublin, CA).

Design

Evaluation of diagnostic test or technology.

Participants

Fifty-four glaucoma subjects with early to moderate visual field defects and 50 age-matched normal subjects.

Testing

Three peripapillary RNFL scans of 1 eye of each subject using Stratus and Cirrus OCT.

Main Outcome Measures

Sensitivity and specificity of average, quadrant, and clock-hour RNFL thickness.

Results

The average age±standard deviation in the normal and glaucoma groups was 62.9±12.7 years (range, 40–84 years) and 67.6±11.4 (range, 42–85 years), respectively (P = 0.05). The glaucoma group consisted of 34 early (average mean deviation, −3.20±1.22 dB) and 20 moderate (average mean deviation, −8.05±1.87 dB) glaucomas. Cirrus OCT sensitivity and specificity for average RNFL abnormal at the 5% level were 83% and 88%, respectively, and at the 1% level were 65% and 100%, respectively. Stratus OCT sensitivity and specificity for average RNFL abnormal at the 5% level were 80% and 94%, respectively, and at the 1% level were 61% and 100%, respectively. For 1 or more abnormal quadrants at the 5% level, the sensitivity and specificity for Cirrus OCT were 98% and 80%, respectively, and at the 1% level were 87% and 92%, respectively. For 1 or more quadrants abnormal at the 5% level, the sensitivity and specificity for Stratus OCT were 96% and 76%, respectively, and at the 1% level were 74% and 94%, respectively. Cirrus OCT sensitivity and specificity using a criterion of 1 or more abnormal clock hours at the 5% level were 100% and 72%, respectively, and at the 1% level were 85% and 94%, respectively. Stratus OCT sensitivity and specificity for 1 or more abnormal clock hours at the 5% level were 98% and 66%, respectively, and at the 1% level were 85% and 90%, respectively.

Conclusions

The sensitivity and specificity of various RNFL parameters using the Cirrus OCT for glaucoma with early to moderate visual field defects are excellent and are equivalent to Stratus OCT.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Patients and Methods

The Human Subject Research Office of the University of Miami Institutional Review Board approved this study. All subjects signed an informed consent form as well as a separate Health Insurance Portability and Accountability Act consent form. Normal and glaucoma subjects were recruited between October 2007 and August 2008 at the Anne Bates Leach Eye Hospital, Miller School of Medicine, University of Miami. Each subject underwent a screening eye examination to determine eligibility. The

Results

The average age±standard deviation in the normal and glaucoma groups was 62.9±12.7 years (range, 40–84 years) and 67.6±11.4 years (range, 42–85 years), respectively (P = 0.05). There were 9 males and 41 females in the normal group (n = 50), with 21 right eyes and 29 left eyes. In the glaucoma group (n = 54), there were 19 males and 35 females, with 26 right eyes and 28 left eyes. There has not been evidence showing that gender affects RNFL thickness measurements.9 By standard visual field

Discussion

Optical coherence tomography, first described in 1991 by Huang et al,9 is a high-resolution, cross-sectional imaging technique using laser and the principle of interferometry to measure the differences in reflected light. This allows direct measurement of the RNFL in vivo. The recent development of spectral-domain technology has enabled the Cirrus OCT instrument to capture much more data in the same amount of time through the use of a spectrometer. Cirrus acquires a 6×6-mm cube of data

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  • Cited by (110)

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    Manuscript no. 2009-212.

    Available online: October 2, 2009.

    Financial Disclosure(s): The author(s) have made the following disclosure(s): The department in which this research was performed receives unrestricted research support from Carl Zeiss Meditec.

    Supported by Research to Prevent Blindness, Inc., New York, New York; the National Institutes of Health, Bethesda, Maryland (grant no.: P30 EY014801); and the Heed Ophthalmic Foundation (RTC), Cleveland, OH.

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