Purpose: To determine the sensitivity and specificity of measurements of the retinal nerve fiber layer (RNFL) using the StratusOCT in glaucoma subjects with visual field (VF) defects.
Design: Prospective cross-sectional study.
Participants: One hundred nine normal and 63 glaucoma subjects.
Testing: Fast RNFL scans were performed in one eye of each patient using the StratusOCT.
Main outcome measures: Sensitivity and specificity of different optical coherence tomography (OCT) criteria for identifying glaucoma subjects with glaucomatous VF defects.
Secondary outcome measures: Areas under the receiver operating characteristic curves (AROCs) for various OCT parameters.
Results: Severity of VF defects in the glaucoma group was distributed between mild (18 subjects), moderate (21 subjects), and severe (24 subjects). The average mean deviation of the glaucoma fields was -8.4 decibels (dB), with a standard deviation of 6.0 dB and a range from -0.14 to -28.0 dB. The sensitivity and specificity using a criterion of average RNFL thickness abnormal at the <5% level were 84% and 98%, respectively. The sensitivity and specificity using a criterion of average RNFL thickness abnormal at the <1% level were 68% and 100%. The sensitivity and specificity of using a criterion of >or=1 quadrants abnormal at the <5% level were 89% and 95%. The sensitivity and specificity of using a criterion of >or=1 quadrants abnormal at the <1% level were 83% and 100%. The sensitivity and specificity of using a criterion of >or=1 clock hours abnormal at the <5% level were 89% and 92%. The sensitivity and specificity of using a criterion of >or=1 quadrants abnormal at the <1% level were 83% and 100%. The AROC for mean RNFL thickness was 0.966. Other high AROC values included the superior quadrant (0.952), inferior quadrant (0.971), inferotemporal clock hour at 7-o'clock (right eye) and 5-o'clock (left eye) (0.959), 6-o'clock hour (0.940), superotemporal clock hour at 11-o'clock (right eye) and 1-o'clock (left eye) (0.935), and 12-o'clock hour (0.924).
Conclusions: The sensitivity and specificity of RNFL measurements using the new StratusOCT for glaucoma with manifest VF defects are excellent. The best parameters seem to be >or=1 quadrants abnormal at the <or=5% level or >or=1 clock hours abnormal at the <or=5% level. Future studies are needed to determine the sensitivity and specificity of this new technology for glaucoma without VF defects.