Quadrant Wise Analysis of RNFL Thickness Measured by Optical Coherence Tomography (Oct) in Primary Open Angle Glaucoma (Poag) and Its Ability to Detect Glaucoma (original) (raw)
Related papers
Purpose – To evaluate macular thickness and peripapillary RNFL thickness to analyse and monitorglaucoma patient Material and method –The present study was conducted in 200 patients who attended OPD of upgraded department of ophthalmology,NSCB Medical college during academic session October 2015-November2017.All All selected patients underwent a complete examination including visual field examination by humphrey'sautomated perimeter and macular scan with retinal nerve fiber layer (RNFL) scan by Spectral Domain-OCT (SD-OCT)after taking proper history and other necessary clinical examination. Correlation of OCT data with visual field defect was evaluated. Result –Macular thickness and RNFL thickness values were significantly reduced in glaucomatous eyes(Avg.GCIPL58±13.19µm,min.GCIPL42.93± 16.92µm and Avg.RNFL thickness58.1415±.76µm) than in healthy eyes(Avg.GCIPL 81.31±4.64µm,min.GCIPL 77.99± 4.95µm and Avg.RNFL thickness91.91. ±6.85µm)and it was correlated well with visual field global indices like MD(-9.07± 6.23) and PSD(6.34±3.36) and average CD ratio (0.75± 0.09) Conclusion – Quantitative measurement of macular thickness and peripapillary RNFL thickness using OCT correlates with visual field global indices in glaucoma patient .In this way we can say that macular and RFNL thickness analysis are excellent modality of analysing and monitoring glaucoma patient.
IP Innovative Publication Pvt. Ltd., 2018
Aims: To quantify and compare the retinal nerve fiber thickness in normal, ocular hypertensive and glaucomatous eyes using Optical coherence tomography (OCT). Materials and Methods: Patients were divided in to three groups of 30 each for normal, ocular hypertensive and primary open angle glaucoma. Inclusion criteria were of patients between 30-70 years of age, visual acuity of 6/36 or better, Refractive error not exceeding 5D and no prior surgery. Complete eye evaluation and was done followed by OCT Scan using the protocol “Fast RNFL thickness”. RNFL thickness was assessed in 4 quadrants and statistical analysis was done using student t test and analysis of variance (ANOVA). Results: RNFL was significantly thinner in OHT eyes than in normal eyes specifically in the inferior and nasal quadrants. 12.6% decrease in RNFL thickness was seen in OHT eyes as compared to normal eyes and about 22.29% decrease in RNFL thickness in POAG eyes as compared to OHT. Conclusions: Incorporation of OCT in glaucoma practice can helped us in evaluation of optic disc, quantifying of RNFL, identifying the structural changes in RNFL and the progression of disease. The magnitude of focal RNFL thinning in OCT was related to the magnitude of decreased global indices sensitivity in glaucomatous patient. Keywords: Low coherence optical tomography, Optic disc, Retinal nerve fiber layer, Visual field
Acta Informatica Medica, 2014
Goal: the purpose of the current study was to estimate the predictive values of optical coherence tomography parameters in early, developed perimetric and terminal glaucoma. Methods: 180 eyes of 120 consecutive patients were evaluated in this retrospective cross sectional pilot study. Copernicus Spectral -domain optical coherence tomography with resolution of 3 mm obtained throught the optic nerve head were included. All examined eyes were divided to four groups (healthy,early, developed perimetric glaucoma and terminal glaucoma). The values of the thicknes of the retinal nerve fibre layer, the size of the disk, the volume of the cup, the E/D parameter and the size of the RIM were compared in four study groups. Results:The sensitivity of RNFL was 90,0%, specificity 82,0 %, positive predictability 83,3 % and negative predictability was 89,1 %. The total accuracy was 86,0 % and area under curve (AUC) was 0,878 for RNFL indeks compering early to developed glaucoma. The sensitivity for CUP was 78%, the specificity was 80,8 %, the positive predictability 81,2% and the negative predictability was 77,5 %. The total accuracy was 79,3 % and area under curve (AUC) was 0,86 compering early to developed glaucoma. The sensitivity for E/D was 82,0%, the specificity was 82,9 % the positive predictability 83,7 % and the negative predictability was 81,3 %. The total accuracy was 82,5 % and area under curve (AUC) for E/D was 0,89 compering eearly to developed glaucoma.The sensitivity for RIM was 78,0%, the specificity was 76,6 %, the positive predictability was 84,7 and the negative predictability was 67,7 %. The total accuracy was 77,5 % and area under curve (AUC) for the RIM compering the developed to terminal glaucoma was 0,792. The sensitivity of RNFL was 88,0 %, the specificity was 66,7 %, the positive predictability was 81,5% and the negative predictability was 76,9%. The total accuracy was 80,0% and the area under curve (AUC) for RNFL compering developed to terminal glaucoma was 0,815. The incrreasing 0,1 unit RNFL decreases the risk of developing glaucoma from early to another developed stage of glaucoma for 6,95%. The increasing of E/D for only one unit increases the risk to develop another stage of glaucoma for 18,75 times. The increasing of RNFL for only one unit decreases the risk of performing developed glaucoma from initial stage for 7,8%. The increasing for only one unit of CUP increases the risk to develop terminal glaucoma for 8,47 times and increasing for 0,1 unit of the value of RIM decreases the risk developing terminal glaucoma for 9,27%. The increasing for 0,01 unit of the E/D index increases the risk for terminal glaucoma for 23,23 times. The increasing for one unit of RNFL decreasing the risk developing terminal glaucoma for 5,7%.
OCT based Comparison of RNFL Thickness in Low to Moderate Myopic Eyes with NORMAL and Raised IOP
International Journal of Science and Research (IJSR), 2016
Purpose: To compare Retinal Nerve Fibre Layer (RNFL) thickness with Optical Coherence Tomography (OCT) in low to moderate myopic eyes with normal & raised Intra Ocular Pressure (IOP) without any other glaucomatous changes. Methods: A Total of 60 low to moderate myopes (spherical equivalent [SE] between-6.0D &-0.5D) with 30 subjects with normal IOP (≤ 21 mmHg) and 30 with raised corrected IOP (≥22mmHg) were included in this cross-sectional study. Three circular scans were obtained for each eye at diameter of 3.4mm around the optic disc using RTVue OCT. A single index of average RNFL thickness throughout 360 degree was obtained. The mean RNFL of (n=60) eyes with raised IOP was compared with age matched randomly selected (n=60) eyes with normal IOP. Results: Mean RNFL was significantly thinner in eyes with raised IOP than in eyes with normal IOP, 91.01 ± 11.95 and 101.52 ± 10.13 respectively. Conclusion: These findings suggest that quantitative differences in RNFL thickness exist between age-matched low to moderate myopic eyes with normal and raised IOP. Thus, all myopic individuals with raised IOP should be considered for OCT to assess for damage of RNFL, as they are at risk of developing glaucoma in future.
RNFL in glaucomatous Nepalese eyes and their relation with visual field sensitivity
Background: To evaluate peripapillary retinal nerve fiber layer (RNFL) thickness in glaucomatous Nepalese eyes using spectral domain optical coherence tomography (SD-OCT) and study its relationship with visual field sensitivity. Methods: A total of 120 eyes comprising primary open angle glaucoma (POAG), glaucoma suspects (GS), normal tension glaucoma (NTG) and healthy subjects (n = 30 cases in each group) underwent a complete ophthalmic examination, including optic nerve head (ONH) evaluation and standard automated perimetry (SAP). RNFL thickness measurements around the optic disk were taken with circular spectral domain optical coherence tomography (SD-OCT) scans. Analysis of variance (ANOVA) was used for comparison of RNFL parameters among various study groups. The relationship of RNFL parameters with visual field (VF) global indices was evaluated with regression analysis. Results: The mean pRNFL thickness was significantly less in the POAG (64.30 ± 14.45 m, p < 0.01), NTG (85.43 ± 9.79 m, p < 0.001) and GS (102.0 ± 9.37 m, p < 0.001) groups than in the healthy group (109.8 ± 8.32 m). The RNFL was significantly thinner across all quadrants in all study group pairs (p < 0.05) except for normal vs. GS (only superior and inferior quadrant, significant). Linear regression plots with RNFL thickness as a predictor of MD and LV demonstrated a strong and statistically significant degree of determination in the POAG group (R 2 = 0.203 and 0.175, p = 0.013 and 0.021).
Saudi Journal of Ophthalmology, 2013
Purpose: To determine the discriminating ability of retinal nerve fiber layer (RNFL) thickness measured with spectral-domain optical coherence tomography (SD-OCT) in different stages of glaucoma. Patients and methods: Thirty normal, 150 glaucomatous eyes were included. Glaucomatous eyes were graded into early, moderate and severe stages according to one of the global indices called visual field index (VFI). Complete ophthalmic examination, white on white perimetry and SD-OCT were done for all patients. RNFL thickness of quadrants and average thickness were recorded. Area under receiver operating characteristic curves (AUCs) were used to assess the performance of OCT parameters. Results: Average, inferior and superior RNFL thickness were the best parameters to discriminate normal from early glaucoma (AUC: 0.91-86), early from moderate (AUC: 0.77-0.70) and moderate from severe (AUC: 0.85-83). Average RNFL loss was 18% in early glaucoma, 28% in moderate glaucoma and 41% in severe glaucoma. Early damage tends to be focal and in the lower quadrant. A significant correlation was detected between mean VFI and mean RNFL loss. Glaucoma was restaged according to average RNFL loss into early: P97.5 l, moderate: <97.5-72.5 l and severe: <72.5 l. Conclusion: RNFL thickness measured with SD-OCT could discriminate the three stages of glaucoma. RNFL loss can be correlated to visual field loss. Future OCT-based staging of glaucoma, adjunctive to perimetry is possible.
Japanese Journal of Ophthalmology, 2013
Purpose To evaluate the capability of optical coherence tomography (OCT), retinal nerve fiber layer (RNFL) thickness, and visual field (VF) measurements in glaucoma progression detection. Methods The study examined 62 eyes of 37 glaucoma patients observed over a 3-year period. All eyes underwent at least four serial RNFL measurements performed by Cirrus OCT, with the first and last measurements separated by at least 3 years. VF testing was performed by using the Swedish interactive threshold algorithm (SITA) Standard 30-2 program of the Humphrey field analyzer (HFA) on the same day as the RNFL imaging. Both serial RNFL thicknesses and VF progression were assessed by the guided progression analysis (GPA) software program. RNFL thickness progression was evaluated by event analysis. Total deviation (TD) in the superior or inferior hemifield was also examined. Results A total of 295 OCT scans and 295 VFs were analyzed. Five eyes exhibited progression by OCT only and 8 eyes exhibited progression by VF GPA only. When the analysis was based on the combined measurement findings, progression was noted in 6 eyes. The average of the progressive hemifield TD at baseline for combined RNFL and VF progression was-3.21 ± 1.38 dB, while it was-2.17 ± 1.14 dB for RNFL progression and-9.12 ± 3.75 dB for VF progression. The average of the progressive hemifield TD indicated a significant advancement of VF progression as compared to RNFL progression (P = 0.002). Conclusions When a mild VF defect is present, OCT RNFL thickness measurements are important in helping discern glaucoma progression.
… ophthalmology & visual …, 2005
PURPOSE. To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes. METHODS. One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols. RESULTS. Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95% confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 m for the average RNFL thickness measurements in normal eyes to 13.8 m for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable. CONCLUSIONS. Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.
Oman Journal of Ophthalmology, 2014
Purpose: To compare the visual field index (VFI) in primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) eyes, and to study the correlation with disc variables on optical coherence tomography (OCT) in all stages of severity. Materials and Methods: Thirty POAG and PACG underwent Humphrey visual field 24-2 along with detailed examination. They also underwent stratus OCT imaging of the optic nerve and retinal nerve fiber layer (RNFL). The correlation of VFI with RNFL thickness was compared in POAG and PACG. Results: The VFI significantly differed between POAG and PACG, with POAG eyes apparently having a better VFI at all severities of glaucoma. There were statistically significant differences in the superior max (Smax) and inferior max (Imax) in early and moderate POAG and PACG eyes. In early and moderate glaucoma, multivariate regression showed that maximum correlation of the VFI was seen with the mean deviation (b = 1.7, P < 0.001), average and superior RNFL thickness (b = 2.1, P < 0.001 and b = 1.8, P = 0.03, respectively), and age (b = 0.7, P = 0.04); while no correlation was seen with intraocular pressure (IOP), axial length, sex, or other clinical variables. VFI did not correlate well with RNFL thickness or other disc variables on OCT in severe glaucoma. Conclusion: VFI may not serve as a useful indicator of visual function in severe glaucoma. More useful indicators are required to monitor glaucoma patients with severe damage.