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1 General aspects (0)   1.1 Epidemiology (5)   1.2 Population genetics (15)   1.3 Pathogenesis (6)   1.4 Quality of life (5)   1.5 Glaucomas as cause of blindness (0)   1.6 Prevention and screening (5) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (2)   2.2 Cornea (3)   2.3 Sclera (0)   2.4 Anterior chamber angle (0)   2.5 Meshwork (16)     2.5.1 Trabecular meshwork (0)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (5)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (14)   2.14 Optic disc (16)   2.15 Optic nerve (0)   2.16 Chiasma and retrochiasmal central nervous system (0)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (9)   3.1 Microscopy (0)   3.2 Electron microscopy (3)   3.3 Immunohistochemistry (1)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (0)   3.5 Molecular biology incl. 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    9.4.1 Steroid-induced glaucoma (2)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (0)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (1)       9.4.4.1 Exfoliation syndrome (7)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (3)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (5)     9.4.7 Glaucomas associated with ocular trauma (0)     9.4.8 Glaucomas associated with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       9.4.11.2 Glaucomas in aphakia and pseudophakia (0)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (3)     9.4.15 Glaucoma in relation to systemic disease (6)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (7) 11 Medical treatment (0)   11.1 General management, indication (9)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (6)     11.3.4 Betablocker (16)     11.3.5 Other (0)   11.4 Prostaglandins (24)   11.5 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tube implant (6)     12.8.2 With tube implant or other drainage devices (9)     12.8.3 Non-perforating (6)     12.8.4 Using laser (1)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (7)     12.8.11 Complications, endophthalmitis (8)   12.9 Trabeculotomy, goniotomy (3)   12.10 Cyclodestruction (4)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (9)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (1)     12.14.3 Phacoemulsification (9)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (6)   12.20 Other (4) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (4) 15 Miscellaneous (4)

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Abstract #8177 Published in IGR 4-3

Optical coherence tomography measurement of nerve fiber layer thickness and the likelihood of a visual field defect

Williams ZY; Schuman JS; Gamell L; Nemi A; Hertzmark E; Fujimoto JG; Mattox C; Simpson J; Wollstein G
American Journal of Ophthalmology 2002; 134: 538-546

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PURPOSE: To determine if optical coherence tomography (OCT) measurements of nerve fiber layer (NFL) thickness can be used to predict the presence of visual field defects (VFD) associated with glaucoma. DESIGN: Quota-sampled, cross-sectional study. METHODS: Retrospective study of OCT NFL thickness measurements in 276 eyes of 276 subjects. All persons received OCT NFL thickness analysis; 136 eyes underwent frequency-doubling technology (FDT) perimetry; and 140 eyes underwent Swedish interactive threshold algorithm (SITA) perimetry. We defined a parameter called NFL⁵⁰, which is the NFL thickness value at which there was a 50% likelihood of a VFD with either SITA or FDT perimetry. The authors evaluated the use of NFL⁵⁰. RESULTS: The mean NFL thickness with (n = 68) and without (n = 68) a VFD in the FDT group was 93.2 μm ± 22.6 and 108.4 μm ± 14.1, respectively. The mean NFL thickness with (n = 70) and without (n = 70) a VFD in the SITA group was 78.9 μm ± 24.8 and 103.0 μm ± 18.0, respectively. The FDT mean NFL⁵⁰ value was 98.5 μm. The SITA mean NFL⁵⁰ value was 87.0 μm. The area under the receiver operator characteristic (AROC) curve for mean NFL was 0.73, and the positive predictive value (PPV) for FDT mean NFL⁵⁰ was 72.2%. For SITA mean NFL, the AROC was 0.79 and the PPV for NFL⁵⁰ was 77.2%. CONCLUSIONS: Nerve fiber layer thickness analysis using OCT may be clinically useful in identifying subjects who have visual field loss. However, the PPV suggests that OCT may need higher resolution and better reproducibility to enhance its sensitivity and specificity for population screening.

Z.Y. Williams, MD New England Eye Center, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA

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Classification:

2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
6.9.2 Optical coherence tomography (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)

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