Abstract #82723 Published in IGR 20-4

Qualitative evaluation of neuroretinal rim and retinal nerve fibre layer on optical coherence tomography to detect glaucomatous damage

Wu Z; Vianna JR; Reis ASC; Zemborain ZZ; Lee SH; Thenappan A; Weng DSD; Weng DSD; Weng DSD; Tsamis E; Tsamis E; Tsamis E; Joiner DB; Joiner DB; Ritch R; De Moraes CGV; Hood DC
British Journal of Ophthalmology 2019; 0:

PURPOSE: To understand the added value of Bruch's membrane opening-minimum rim width (BMO-MRW) measurements to conventional circumpapillary retinal nerve fibre layer (cpRNFL) thickness measurements on optical coherence tomography (OCT) imaging for discriminating between perimetric glaucoma and healthy eyes, evaluated through a qualitative evaluation. METHODS: 384 healthy eyes and 188 glaucoma eyes were evaluated, and glaucoma eyes were categorised as perimetric (n=107) based on a history of ≥3 consecutive abnormal 24-2 visual field tests or suspected glaucoma if they did not (n=81). OCT-derived BMO-MRW and cpRNFL reports were qualitatively evaluated by two experienced graders in isolation at first, and then by using both reports combined. The diagnostic performance (sensitivity at 95% specificity, total and partial area under the receiver operating characteristic curve) of detecting perimetric glaucoma with each method were compared. RESULTS: All diagnostic performance measures for detecting perimetric glaucoma eyes were not significantly different when using either the cpRNFL or BMO-MRW reports alone compared with using both reports combined (p≥0.190), nor when comparing the use of each report in isolation (p≥0.500). CONCLUSIONS: Experienced graders exhibited no difference in discriminating between perimetric glaucoma and healthy eyes when using a cpRNFL report alone, the BMO-MRW report alone or the two reports combined. Therefore, either OCT imaging report of the neuroretinal tissue could be used effectively for detecting perimetric glaucoma, but further studies are needed to determine whether there are specific advantages of each method, or the combination of both, when evaluating eyes that have a greater degree of diagnostic uncertainty.

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2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
2.12 Choroid, peripapillary choroid, peripapillary atrophy (Part of: 2 Anatomical structures in glaucoma)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma) Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)

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