Population-based evaluation of retinal nerve fiber layer, retinal ganglion cell layer, and inner plexiform layer as a diagnostic tool for glaucoma

Henriët Springelkamp; Kyungmoo Lee; Roger C W Wolfs; Gabriëlle H S Buitendijk; Wishal D Ramdas; Albert Hofman; Johannes R Vingerling; Caroline C W Klaver; Michael D Abràmoff; Nomdo M Jansonius

doi:10.1167/iovs.14-15506

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Population-based evaluation of retinal nerve fiber layer, retinal ganglion cell layer, and inner plexiform layer as a diagnostic tool for glaucoma

Journal article

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Population-based evaluation of retinal nerve fiber layer, retinal ganglion cell layer, and inner plexiform layer as a diagnostic tool for glaucoma

Henriët Springelkamp, Kyungmoo Lee, Roger C W Wolfs, Gabriëlle H S Buitendijk, Wishal D Ramdas, Albert Hofman, Johannes R Vingerling, Caroline C W Klaver, Michael D Abràmoff and Nomdo M Jansonius

Investigative ophthalmology & visual science, Vol.55(12), pp.8428-8438

11/20/2014

DOI: 10.1167/iovs.14-15506

PMCID: PMC4280090

PMID: 25414193

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Abstract

We determined the glaucoma screening performance of regional optical coherence tomography (OCT) layer thickness measurements in the peripapillary and macular region, in a population-based setting. Subjects (n = 1224) in the Rotterdam Study underwent visual field testing (Humphrey Field Analyzer) and OCT of the macula and optic nerve head (Topcon 3-D OCT-1000). We determined the mean thicknesses of the retinal nerve fiber layer (RNFL), retinal ganglion cell layer (RGCL), and inner plexiform layer for regions-of-interest; thus, defining a series of OCT parameters, using the Iowa Reference Algorithms. Reference standard was the presence of glaucomatous visual field loss (GVFL); controls were subjects without GVFL, an intraocular pressure (IOP) of 21 mm Hg or less, and no positive family history for glaucoma. We calculated the area under the receiver operating characteristics curve (AUCs) and the sensitivity at 97.5% specificity for each parameter. After excluding 23 subjects with an IOP > 21 mm Hg and 73 subjects with a positive family history for glaucoma, there were 1087 controls and 41 glaucoma cases. Mean RGCL thickness in the inferior half of the macular region showed the highest AUC (0.85; 95% confidence interval [CI] 0.77-0.92) and sensitivity (53.7%; 95% CI, 38.7-68.0%). The mean thickness of the peripapillary RNFL had an AUC of 0.77 (95% CI, 0.69-0.85) and a sensitivity of 24.4% (95% CI, 13.7-39.5%). Macular RGCL loss is at least as common as peripapillary RNFL abnormalities in population-based glaucoma cases. Screening for glaucoma using OCT-derived regional thickness identifies approximately half of those cases of glaucoma as diagnosed by perimetry.

Nerve Fibers - pathology

Area Under Curve

Intraocular Pressure

Humans

Male

Glaucoma - diagnosis

Tomography, Optical Coherence - methods

Case-Control Studies

Retinal Ganglion Cells - pathology

Reference Standards

Sensitivity and Specificity

Aged, 80 and over

Tomography, Optical Coherence - standards

Female

Aged

Glaucoma - pathology

Visual Field Tests

Optic Disk - pathology

Macula Lutea - pathology

Details

Title: Subtitle: Population-based evaluation of retinal nerve fiber layer, retinal ganglion cell layer, and inner plexiform layer as a diagnostic tool for glaucoma
Creators: Henriët Springelkamp - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Kyungmoo Lee - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
Roger C W Wolfs - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
Gabriëlle H S Buitendijk - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Wishal D Ramdas - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Albert Hofman - Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, The Hague, The Netherlands
Johannes R Vingerling - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Caroline C W Klaver - Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Michael D Abràmoff - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
Nomdo M Jansonius - Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Resource Type: Journal article
Publication Details: Investigative ophthalmology & visual science, Vol.55(12), pp.8428-8438
Publisher: United States
DOI: 10.1167/iovs.14-15506
PMID: 25414193
PMCID: PMC4280090
ISSN: 0146-0404
eISSN: 1552-5783
Grant note: R01 EY019112 / NEI NIH HHS I01 CX000119 / CSRD VA R01 EY018853 / NEI NIH HHS
Language: English
Date published: 11/20/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Ophthalmology and Visual Sciences
Record Identifier: 9983806365702771

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