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Influence of optic disc size on the diagnostic performance of macular ganglion cell complex and peripapillary retinal nerve fiber layer analyses in glaucoma.

Cordeiro DV, Lima VC, Castro DP, Castro LC, Pacheco MA, Lee JM, Dimantas MI, Prata TS - Clin Ophthalmol (2011)

Bottom Line: Similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19).The highest sensitivities - at 80% specificity for average pRNFL (84.5%) and GCC thicknesses (74.5%) - were found with disc sizes fixed at 1.5 mm(2) and 2.5 mm(2).For GCC analysis, an inverse effect was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Federal University of São Paulo, São Paulo.

ABSTRACT

Aim: To evaluate the influence of optic disc size on the diagnostic accuracy of macular ganglion cell complex (GCC) and conventional peripapillary retinal nerve fiber layer (pRNFL) analyses provided by spectral domain optical coherence tomography (SD-OCT) in glaucoma.

Methods: Eighty-two glaucoma patients and 30 healthy subjects were included. All patients underwent GCC (7 × 7 mm macular grid, consisting of RNFL, ganglion cell and inner plexiform layers) and pRNFL thickness measurement (3.45 mm circular scan) by SD-OCT. One eye was randomly selected for analysis. Initially, receiver operating characteristic (ROC) curves were generated for different GCC and pRNFL parameters. The effect of disc area on the diagnostic accuracy of these parameters was evaluated using a logistic ROC regression model. Subsequently, 1.5, 2.0, and 2.5 mm(2) disc sizes were arbitrarily chosen (based on data distribution) and the predicted areas under the ROC curves (AUCs) and sensitivities were compared at fixed specificities for each.

Results: Average mean deviation index for glaucomatous eyes was -5.3 ± 5.2 dB. Similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19). The coefficient representing disc area in the ROC regression model was not statistically significant for average pRNFL thickness (-0.176) or average GCC thickness (0.088; P ≥ 0.56). AUCs for fixed disc areas (1.5, 2.0, and 2.5 mm(2)) were 0.904, 0.891, and 0.875 for average pRNFL thickness and 0.834, 0.842, and 0.851 for average GCC thickness, respectively. The highest sensitivities - at 80% specificity for average pRNFL (84.5%) and GCC thicknesses (74.5%) - were found with disc sizes fixed at 1.5 mm(2) and 2.5 mm(2).

Conclusion: Diagnostic accuracy was similar between pRNFL and GCC thickness parameters. Although not statistically significant, there was a trend for a better diagnostic accuracy of pRNFL thickness measurement in cases of smaller discs. For GCC analysis, an inverse effect was observed.

No MeSH data available.


Related in: MedlinePlus

ROC curves for SD-OCT thickness parameters. Similar AUCs were found for average pRNFL thickness (0.872) and average GCC thickness (0.824; P = 0.19).Abbreviations: pRNFL, peripapillary retinal nerve fiber layer; GCC, ganglion cell complex; AUC, area under the ROC curve; SD-OCT, spectral domain optical coherence tomography.
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f1-opth-5-1333: ROC curves for SD-OCT thickness parameters. Similar AUCs were found for average pRNFL thickness (0.872) and average GCC thickness (0.824; P = 0.19).Abbreviations: pRNFL, peripapillary retinal nerve fiber layer; GCC, ganglion cell complex; AUC, area under the ROC curve; SD-OCT, spectral domain optical coherence tomography.

Mentions: The AUCs for average, superior, and inferior GCC thickness were not significantly different at 0.824, 0.823, and 0.791, respectively (P ≥ 0.13). The AUCs for average, superior, and inferior pRNFL thickness were also similar at 0.872, 0.816, and 0.845, respectively (P ≥ 0.09). Finally, similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19) (Figure 1).


Influence of optic disc size on the diagnostic performance of macular ganglion cell complex and peripapillary retinal nerve fiber layer analyses in glaucoma.

Cordeiro DV, Lima VC, Castro DP, Castro LC, Pacheco MA, Lee JM, Dimantas MI, Prata TS - Clin Ophthalmol (2011)

ROC curves for SD-OCT thickness parameters. Similar AUCs were found for average pRNFL thickness (0.872) and average GCC thickness (0.824; P = 0.19).Abbreviations: pRNFL, peripapillary retinal nerve fiber layer; GCC, ganglion cell complex; AUC, area under the ROC curve; SD-OCT, spectral domain optical coherence tomography.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3198406&req=5

f1-opth-5-1333: ROC curves for SD-OCT thickness parameters. Similar AUCs were found for average pRNFL thickness (0.872) and average GCC thickness (0.824; P = 0.19).Abbreviations: pRNFL, peripapillary retinal nerve fiber layer; GCC, ganglion cell complex; AUC, area under the ROC curve; SD-OCT, spectral domain optical coherence tomography.
Mentions: The AUCs for average, superior, and inferior GCC thickness were not significantly different at 0.824, 0.823, and 0.791, respectively (P ≥ 0.13). The AUCs for average, superior, and inferior pRNFL thickness were also similar at 0.872, 0.816, and 0.845, respectively (P ≥ 0.09). Finally, similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19) (Figure 1).

Bottom Line: Similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19).The highest sensitivities - at 80% specificity for average pRNFL (84.5%) and GCC thicknesses (74.5%) - were found with disc sizes fixed at 1.5 mm(2) and 2.5 mm(2).For GCC analysis, an inverse effect was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Federal University of São Paulo, São Paulo.

ABSTRACT

Aim: To evaluate the influence of optic disc size on the diagnostic accuracy of macular ganglion cell complex (GCC) and conventional peripapillary retinal nerve fiber layer (pRNFL) analyses provided by spectral domain optical coherence tomography (SD-OCT) in glaucoma.

Methods: Eighty-two glaucoma patients and 30 healthy subjects were included. All patients underwent GCC (7 × 7 mm macular grid, consisting of RNFL, ganglion cell and inner plexiform layers) and pRNFL thickness measurement (3.45 mm circular scan) by SD-OCT. One eye was randomly selected for analysis. Initially, receiver operating characteristic (ROC) curves were generated for different GCC and pRNFL parameters. The effect of disc area on the diagnostic accuracy of these parameters was evaluated using a logistic ROC regression model. Subsequently, 1.5, 2.0, and 2.5 mm(2) disc sizes were arbitrarily chosen (based on data distribution) and the predicted areas under the ROC curves (AUCs) and sensitivities were compared at fixed specificities for each.

Results: Average mean deviation index for glaucomatous eyes was -5.3 ± 5.2 dB. Similar AUCs were found for the best pRNFL (average thickness = 0.872) and GCC parameters (average thickness = 0.824; P = 0.19). The coefficient representing disc area in the ROC regression model was not statistically significant for average pRNFL thickness (-0.176) or average GCC thickness (0.088; P ≥ 0.56). AUCs for fixed disc areas (1.5, 2.0, and 2.5 mm(2)) were 0.904, 0.891, and 0.875 for average pRNFL thickness and 0.834, 0.842, and 0.851 for average GCC thickness, respectively. The highest sensitivities - at 80% specificity for average pRNFL (84.5%) and GCC thicknesses (74.5%) - were found with disc sizes fixed at 1.5 mm(2) and 2.5 mm(2).

Conclusion: Diagnostic accuracy was similar between pRNFL and GCC thickness parameters. Although not statistically significant, there was a trend for a better diagnostic accuracy of pRNFL thickness measurement in cases of smaller discs. For GCC analysis, an inverse effect was observed.

No MeSH data available.


Related in: MedlinePlus