Enhanced Diagnostic Capability for Glaucoma of 3-Dimensional Versus 2-Dimensional Neuroretinal Rim Parameters Using Spectral Domain Optical Coherence Tomography

J Glaucoma. 2017 May;26(5):450-458. doi: 10.1097/IJG.0000000000000647.

Abstract

Purpose: To compare the diagnostic capability of 3-dimensional (3D) neuroretinal rim parameters with existing 2-dimensional (2D) neuroretinal and retinal nerve fiber layer (RNFL) thickness rim parameters using spectral domain optical coherence tomography (SD-OCT) volume scans.

Materials and methods: Design: Institutional prospective pilot study.

Study population: 65 subjects (35 open-angle glaucoma patients, 30 normal patients).

Observation procedures: One eye of each subject was included. SD-OCT was used to obtain 2D RNFL thickness values and 5 neuroretinal rim parameters [ie, 3D minimum distance band (MDB) thickness, 3D Bruch's membrane opening-minimum rim width (BMO-MRW), 3D rim volume, 2D rim area, and 2D rim thickness].

Main outcome measures: Area under the receiver operating characteristic curve values, sensitivity, and specificity.

Results: Comparing all 3D with all 2D parameters, 3D rim parameters (MDB, BMO-MRW, rim volume) generally had higher area under the receiver operating characteristic curve values (range, 0.770 to 0.946) compared with 2D parameters (RNFL thickness, rim area, rim thickness; range, 0.678 to 0.911). For global region analyses, all 3D rim parameters (BMO-MRW, rim volume, MDB) were equal to or better than 2D parameters (RNFL thickness, rim area, rim thickness; P-values from 0.023 to 1.0). Among the three 3D rim parameters (MDB, BMO-MRW, and rim volume), there were no significant differences in diagnostic capability (false discovery rate >0.05 at 95% specificity).

Conclusions: 3D neuroretinal rim parameters (MDB, BMO-MRW, and rim volume) demonstrated better diagnostic capability for primary and secondary open-angle glaucomas compared with 2D neuroretinal parameters (rim area, rim thickness). Compared with 2D RNFL thickness, 3D neuroretinal rim parameters have the same or better diagnostic capability.

MeSH terms

  • Aged
  • Female
  • Glaucoma, Open-Angle / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Optic Disk / diagnostic imaging
  • Optic Disk / pathology*
  • Pilot Projects
  • Prospective Studies
  • ROC Curve
  • Retinal Ganglion Cells / pathology*
  • Sensitivity and Specificity
  • Tomography, Optical Coherence / methods*