Diagnostic accuracy of posterior pole asymmetry analysis parameters of spectralis optical coherence tomography in detecting early unilateral glaucoma

• Published in: Indian journal of ophthalmology Vol. 63; no. 11; pp. 837 - 842
• Main Authors: Dave, Paaraj, Shah, Juhi
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01.11.2015; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Aged; Asymmetry; Classification; Conflicts of interest; Cross-Sectional Studies; Defects; Diagnosis; Early; Early Diagnosis; Female; Glaucoma; Glaucoma, Open-Angle - diagnosis; Humans; Intraocular Pressure - physiology; Male; Medical research; Methods; Middle Aged; Nerve Fibers - pathology; Optic Disk - pathology; Optic Nerve Diseases - diagnosis; Optical tomography; Optics; Original; posterior pole asymmetry analysis; Precision medicine; Prospective Studies; Reproducibility of Results; Retinal Ganglion Cells - pathology; spectral domain optical coherence tomography; Tomography, Optical Coherence; Tonometry, Ocular; Visual Acuity - physiology; Visual Field Tests; California; Early; posterior pole asymmetry analysis; spectral domain optical coherence tomography; glaucoma
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/0301-4738.171965

Purpose: To report the diagnostic ability of posterior pole asymmetry analysis (PPAA) parameters of spectralis optical coherence tomography (OCT) in detecting early unilateral glaucoma. Methods: A prospective, cross-sectional study which included 80 eyes of 80 normal subjects and 76 eyes of 76 patients with unilateral early primary open-angle glaucoma by Hodapp-Anderson-Parrish classification. All subjects were of age more than 18 years, best-corrected visual acuity 20/40 or better, and a refractive error within ± 5 diopter (D) sphere and ± 3 D cylinder. Control subjects had a normal ocular examination, intraocular pressure (IOP) <22 mmHg, no past history of high IOP, no family history of glaucoma, normal optic disc morphology, and visual field in both eyes. One eye of the control subject was randomly included. All eyes underwent OCT for retinal nerve fiber layer (RNFL) analysis and PPAA. The number of continuous black squares was noted in the asymmetry analysis (right-left + hemisphere asymmetry). The area under curve (AUC) was calculated for all OCT parameters. Results: The best value for AUC for RNFL analysis was 0.858 for the inferotemporal quadrant thickness. This was similar to the best value for AUC for PPAA which was 0.833 for the inferior macular thickness parameter (P = 0.5). The AUC for the right-left and the hemisphere asymmetry part of PPAA was 0.427 and 0.499, respectively. Conclusion: The macular thickness PPAA parameters were equally good as the RNFL parameters. However, the asymmetry analysis parameters performed poorly and need further refinement before its use in early unilateral glaucoma diagnosis.