Universität zu Köln

Enders, Philip ORCID: 0000-0002-9527-4957, Schaub, Friederike, Adler, Werner ORCID: 0000-0001-9791-5407, Nikoluk, Roman, Hermann, Manuel M. and Heindl, Ludwig M. (2017). The use of Bruch's membrane opening-based optical coherence tomography of the optic nerve head for glaucoma detection in microdiscs. Br. J. Ophthalmol., 101 (4). S. 530 - 536. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2079

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Abstract

Purpose To assess the performance of Bruch's membrane opening (BMO)-based spectral domain optical coherence tomography (SD-OCT) of the optic nerve head for glaucoma detection in microdiscs in comparison with confocal scanning laser tomography (CSLT). Design Retrospective cohort study. Methods 82 eyes of 82 patients with disc size < 1.63 mm(2) underwent SD-OCT and CSLT measurements, visual field testing and clinical examination. BMO-based minimal rim width (BMO-MRW), retinal nerve fibre layer thickness (RNFLT) in SD-OCT and rim area measured in CSLT were compared and correlated with visual field defects. Results 51 patients with glaucoma, 11 patients with ocular hypertension (OHT) and 20 healthy controls had a mean disc area of 1.36 +/- 0.19 mm2 in CSLT, and BMO area was 1.45 +/- 0.22 mm(2) (r=0.17; p=0.12). In patients with glaucoma, visual field mean defect was -7.5 +/- 6.7 dB. Global BMO-MRW correlated better with visual field function (Spearman's r=0.65; p<0.001) than RNFLT (r=0.58; p <= 0.001) and CSLT rim area (r=0.47; p=0.004). BMO-MRW significantly deteriorated with progressive visual field loss (p<0.001). In receiver operating characteristic analysis, sensitivity of BMO-MRW was 68.6% at 95% specificity (area under curve (AUC)=0.87), similar to sensitivity of RNFLT (66.4%; AUC=0.81). Performance of CSLT rim area was significantly worse (AUC=0.70, p=0.008). In healthy controls, mean BMO-MRW was 344.3 +/- 64.1 mm, mean RNFLT 78.0 +/- 11.3 mm and CSLT mean rim area 1.07 +/- 0.18 mm(2). Conclusions In small optic discs, BMO-MRW and peripapillary RNFLT (OCT) have similar sensitivity to discriminate patients with glaucoma from normal controls; both exceed CSLT rim area in diagnostic power. In glaucomatous patients, BMO-MRW correlates strongest with visual field function.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Enders, Philip UNSPECIFIED orcid.org/0000-0002-9527-4957 UNSPECIFIED Schaub, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Werner UNSPECIFIED orcid.org/0000-0001-9791-5407 UNSPECIFIED Nikoluk, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermann, Manuel M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-234420
DOI:	10.1136/bjophthalmol-2016-308957
Journal or Publication Title:	Br. J. Ophthalmol.
Volume:	101
Number:	4
Page Range:	S. 530 - 536
Date:	2017
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-2079
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SCANNING LASER OPHTHALMOSCOPY; FIBER LAYER THICKNESS; VISUAL-FIELD DEFECTS; SPECTRAL-DOMAIN OCT; DISC MARGIN ANATOMY; RIM; PERIMETRY; POLARIMETRY; EYES Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23442