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Evaluation of two‐dimensional Bruch's membrane opening minimum rim area for glaucoma diagnostics in a large patient cohort
Author(s) -
Enders Philip,
Adler Werner,
Kiessling David,
Weber Vincent,
Schaub Friederike,
Hermann Manuel M.,
Dietlein Thomas,
Cursiefen Claus,
Heindl Ludwig M.
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13698
Subject(s) - bruch's membrane , medicine , glaucoma , ophthalmology , retinal , visual field , optical coherence tomography , receiver operating characteristic , optic nerve , open angle glaucoma , nerve fiber layer , nuclear medicine , retinal pigment epithelium
Purpose To characterize the two‐dimensional parameter Bruch's membrane opening minimum rim area ( BMO ‐ MRA ) in spectral domain optical coherence tomography ( SD ‐ OCT ) of the optic nerve head ( ONH ) compared to minimum rim width ( BMO ‐ MRW ) and retinal nerve fibre layer ( RNFL ) thickness in a large patient cohort. Methods Case–control, cross‐sectional study of 705 eyes of 445 participants. A total of 449 eyes with glaucoma, 67 eyes with ocular hypertension and 189 healthy controls, underwent SD ‐ OCT and confocal laser scanning tomography ( CSLT ), visual field testing and clinical examination. Morphometric ONH parameters, visual field function and diagnostic power were compared. Main outcome measures were SD ‐ OCT ‐derived BMO ‐ MRA , BMO ‐ MRW , RNFL thickness and CSLT ‐derived rim area ( DM ‐ RA ). Results Mean ONH area was 2.11 ± 0.57 mm 2 ; mean BMO area was 1.89 ± 0.45 mm 2 . Correlation of mean deviation in visual field to morphometric parameters was ρ = 0.70, (p < 0.001) for RNFL thickness, ρ = 0.68 (p < 0.001) for BMO ‐ MRA , ρ = 0.66 (p < 0.001) for BMO ‐ MRW . These correlations were not significantly different (p > 0.05), while DM ‐ RA correlated significantly worse ( ρ = 0.55; p < 0.001). In receiver operating characteristics, the calculated area under the curve ( AUC ) and sensitivity at 90% specificity to differentiate glaucoma were 0.87% and 70.1% for BMO ‐ MRA , 0.86% and 68.1% for RNFL thickness, 0.84% and 66.0% for BMO ‐ MRW , 0.82% and 51.3% for DM ‐ RA . Conclusions In a heterogenous clinical cohort of glaucoma patients, all analysed SD ‐ OCT parameters excel DM ‐ RA of CSLT . The two‐dimensional parameter BMO ‐ MRA shows comparable levels of diagnostic power to detect glaucoma compared to established parameters BMO ‐ MRW and RNFL thickness. Given higher comparability between ONH sizes, BMO ‐ MRA might become an additional standard tool in SD ‐ OCT imaging for glaucoma.