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Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study.
Ophthalmology. 2005 Mar; 112(3):391-400.O

Abstract

OBJECTIVE

To evaluate macular nerve fiber layer (NFL) thickness in glaucomatous damage by optical coherence tomography (OCT) and to compare its discriminating power for glaucoma and glaucoma suspects with that of total macular thickness and peripapillary NFL thickness.

DESIGN

Cross-sectional, case-control, comparative study.

PARTICIPANTS

A total of 133 eyes from 133 subjects including 46 normal eyes, 48 glaucoma-suspect eyes, and 39 glaucoma eyes were enrolled.

METHODS

Macular NFL thickness, total macular thickness, and peripapillary NFL thickness were measured by Stratus OCT in each diagnostic group.

MAIN OUTCOME MEASURES

The patterns and measurements of macular NFL, total macular, and peripapillary NFL thickness in total mean, 4 quadrants, and 12 clock hours. The discriminating power of each parameter for detection of glaucoma suspects and glaucoma was evaluated by areas under the receiver operating characteristic curve (AROC). Correspondence with visual field function was studied by linear regression analysis.

RESULTS

The macular NFL profile exhibited a double-hump pattern with peaks over superonasal and inferonasal sectors. A significant difference in macular NFL thickness between normal and glaucoma-suspect groups was found at the 6-o'clock position, whereas a difference was found in all except the temporal clock hours between normal and glaucoma subjects. No significant difference in AROCs for detection of glaucoma suspects or glaucoma was found when macular NFL thickness and total macular thickness measurements were compared. However, mean macular NFL thickness demonstrated a stronger correlation with visual function than mean macular thickness (r = 0.39/R2 = 0.15 vs. r = 0.23/R2 = 0.05, P =0.042). Among all the findings, inferior peripapillary NFL thickness had the best performance in discriminating glaucoma (AROC, 0.91) and glaucoma suspects (AROC, 0.67). It also had the strongest correlation with visual function (r = 0.60/R2 = 0.36, P<0.001).

CONCLUSIONS

Macular NFL thickness was significantly reduced in glaucoma. It had a similar discriminating power for glaucoma detection but a stronger correlation with visual function than total macular thickness. Peripapillary NFL thickness, however, outperformed both total macular and macular NFL thickness in terms of glaucoma detection and visual function correlation. Peripapillary NFL thickness, as a total measurement of both macular and peripheral NFL, is still the best surrogate marker in glaucoma assessment.

Authors+Show Affiliations

Department of Ophthalmology, Caritas Medical Centre, Hong Kong, China. tlims00@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15745764

Citation

Leung, Christopher K S., et al. "Comparison of Macular and Peripapillary Measurements for the Detection of Glaucoma: an Optical Coherence Tomography Study." Ophthalmology, vol. 112, no. 3, 2005, pp. 391-400.
Leung CK, Chan WM, Yung WH, et al. Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study. Ophthalmology. 2005;112(3):391-400.
Leung, C. K., Chan, W. M., Yung, W. H., Ng, A. C., Woo, J., Tsang, M. K., & Tse, R. K. (2005). Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study. Ophthalmology, 112(3), 391-400.
Leung CK, et al. Comparison of Macular and Peripapillary Measurements for the Detection of Glaucoma: an Optical Coherence Tomography Study. Ophthalmology. 2005;112(3):391-400. PubMed PMID: 15745764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study. AU - Leung,Christopher K S, AU - Chan,Wai-Man, AU - Yung,Wing-Ho, AU - Ng,Alan C K, AU - Woo,Jackson, AU - Tsang,Moon-Kong, AU - Tse,Raymond K K, PY - 2004/04/26/received PY - 2004/10/01/accepted PY - 2005/3/5/pubmed PY - 2005/3/16/medline PY - 2005/3/5/entrez SP - 391 EP - 400 JF - Ophthalmology JO - Ophthalmology VL - 112 IS - 3 N2 - OBJECTIVE: To evaluate macular nerve fiber layer (NFL) thickness in glaucomatous damage by optical coherence tomography (OCT) and to compare its discriminating power for glaucoma and glaucoma suspects with that of total macular thickness and peripapillary NFL thickness. DESIGN: Cross-sectional, case-control, comparative study. PARTICIPANTS: A total of 133 eyes from 133 subjects including 46 normal eyes, 48 glaucoma-suspect eyes, and 39 glaucoma eyes were enrolled. METHODS: Macular NFL thickness, total macular thickness, and peripapillary NFL thickness were measured by Stratus OCT in each diagnostic group. MAIN OUTCOME MEASURES: The patterns and measurements of macular NFL, total macular, and peripapillary NFL thickness in total mean, 4 quadrants, and 12 clock hours. The discriminating power of each parameter for detection of glaucoma suspects and glaucoma was evaluated by areas under the receiver operating characteristic curve (AROC). Correspondence with visual field function was studied by linear regression analysis. RESULTS: The macular NFL profile exhibited a double-hump pattern with peaks over superonasal and inferonasal sectors. A significant difference in macular NFL thickness between normal and glaucoma-suspect groups was found at the 6-o'clock position, whereas a difference was found in all except the temporal clock hours between normal and glaucoma subjects. No significant difference in AROCs for detection of glaucoma suspects or glaucoma was found when macular NFL thickness and total macular thickness measurements were compared. However, mean macular NFL thickness demonstrated a stronger correlation with visual function than mean macular thickness (r = 0.39/R2 = 0.15 vs. r = 0.23/R2 = 0.05, P =0.042). Among all the findings, inferior peripapillary NFL thickness had the best performance in discriminating glaucoma (AROC, 0.91) and glaucoma suspects (AROC, 0.67). It also had the strongest correlation with visual function (r = 0.60/R2 = 0.36, P<0.001). CONCLUSIONS: Macular NFL thickness was significantly reduced in glaucoma. It had a similar discriminating power for glaucoma detection but a stronger correlation with visual function than total macular thickness. Peripapillary NFL thickness, however, outperformed both total macular and macular NFL thickness in terms of glaucoma detection and visual function correlation. Peripapillary NFL thickness, as a total measurement of both macular and peripheral NFL, is still the best surrogate marker in glaucoma assessment. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/15745764/Comparison_of_macular_and_peripapillary_measurements_for_the_detection_of_glaucoma:_an_optical_coherence_tomography_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(04)01654-9 DB - PRIME DP - Unbound Medicine ER -