Sensitivity and Specificity of the StratusOCT for Perimetric Glaucoma

Ophthalmology. 2005 Jan;112(1):3-9. doi: 10.1016/j.ophtha.2004.06.039.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diagnostic Techniques, Ophthalmological*
  • Female
  • Glaucoma / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results
  • Retinal Ganglion Cells / pathology*
  • Sensitivity and Specificity
  • Tomography, Optical Coherence / methods*
  • Vision Disorders / diagnosis*
  • Visual Field Tests
  • Visual Fields*