Detection of Localized Retinal Nerve Fiber Layer Defects in Glaucoma Using Enhanced Spectral-Domain Optical Coherence Tomography

Objective To compare retinal nerve fiber layer (RNFL) defects on fundus photographs with circumpapillary RNFL (cpRNFL) thinning or disruption on images obtained by speckle-noise–reduced spectral-domain optical coherence tomography (enhanced SD OCT), single-scan SD OCT, and single-scan time-domain OC...

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Veröffentlicht in:Ophthalmology (Rochester, Minn.) Minn.), 2011-06, Vol.118 (6), p.1038-1048
Hauptverfasser: Nukada, Masayuki, MD, Hangai, Masanori, MD, Mori, Satoshi, MD, Nakano, Noriko, MD, Nakanishi, Hideo, MD, Ohashi-Ikeda, Hanako, MD, Nonaka, Atsushi, MD, Yoshimura, Nagahisa, MD
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container_issue 6
container_start_page 1038
container_title Ophthalmology (Rochester, Minn.)
container_volume 118
creator Nukada, Masayuki, MD
Hangai, Masanori, MD
Mori, Satoshi, MD
Nakano, Noriko, MD
Nakanishi, Hideo, MD
Ohashi-Ikeda, Hanako, MD
Nonaka, Atsushi, MD
Yoshimura, Nagahisa, MD
description Objective To compare retinal nerve fiber layer (RNFL) defects on fundus photographs with circumpapillary RNFL (cpRNFL) thinning or disruption on images obtained by speckle-noise–reduced spectral-domain optical coherence tomography (enhanced SD OCT), single-scan SD OCT, and single-scan time-domain OCT (TD OCT). Design Retrospective, comparative case series. Participants Forty-four eyes of 44 patients with open-angle glaucoma with localized, wedge-shaped RNFL defects on red-free photographs and 35 normal eyes of 35 volunteers. Methods Cross-sectional images of the cpRNFL and cpRNFL thinning, compared with the confidence interval limit of the normative database where the RNFL defect was photographically identified, were compared between the 3 types of OCT instruments: enhanced SD OCT (SD OCT with eye tracking and averaging of 16 images at the same location to reduce speckle noise; Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany), single-scan SD OCT (RTVue-100; Optovue, Fremont, CA), and single-scan TD OCT (Stratus; Carl Zeiss-Meditec, Dublin, CA). Main Outcome Measures Cross-sectional images of localized RNFL defects on red-free fundus photographs, sensitivity for detecting the photographic RNFL defect, and sensitivity and specificity for detecting glaucoma as having at least 1 abnormally thinned sector on the cpRNFL thickness map on OCT. Results Among the 44 eyes with glaucoma, 65 RNFL defects were identified on red-free fundus photographs. The cpRNFL boundaries were clearer on enhanced SD OCT images than on single-scan SD OCT or TD OCT images, particularly in regions corresponding to the RNFL defects. Enhanced SD OCT revealed various degrees of cpRNFL thinning, and disruption of cpRNFL reflectivity was seen in the same location as the photographic RNFL defect for 23 (35.4%) of the 65 RNFL defects. The RNFL defects were significantly less likely to be detected by single-scan TD OCT or SD OCT ( P = 0.002 and P = 0.006, respectively) when the RNFL was not disrupted. Enhanced SD OCT was more sensitive in detecting the RNFL defects that were not disrupted compared with single-scan TD OCT ( P
doi_str_mv 10.1016/j.ophtha.2010.10.025
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Design Retrospective, comparative case series. Participants Forty-four eyes of 44 patients with open-angle glaucoma with localized, wedge-shaped RNFL defects on red-free photographs and 35 normal eyes of 35 volunteers. Methods Cross-sectional images of the cpRNFL and cpRNFL thinning, compared with the confidence interval limit of the normative database where the RNFL defect was photographically identified, were compared between the 3 types of OCT instruments: enhanced SD OCT (SD OCT with eye tracking and averaging of 16 images at the same location to reduce speckle noise; Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany), single-scan SD OCT (RTVue-100; Optovue, Fremont, CA), and single-scan TD OCT (Stratus; Carl Zeiss-Meditec, Dublin, CA). Main Outcome Measures Cross-sectional images of localized RNFL defects on red-free fundus photographs, sensitivity for detecting the photographic RNFL defect, and sensitivity and specificity for detecting glaucoma as having at least 1 abnormally thinned sector on the cpRNFL thickness map on OCT. Results Among the 44 eyes with glaucoma, 65 RNFL defects were identified on red-free fundus photographs. The cpRNFL boundaries were clearer on enhanced SD OCT images than on single-scan SD OCT or TD OCT images, particularly in regions corresponding to the RNFL defects. Enhanced SD OCT revealed various degrees of cpRNFL thinning, and disruption of cpRNFL reflectivity was seen in the same location as the photographic RNFL defect for 23 (35.4%) of the 65 RNFL defects. The RNFL defects were significantly less likely to be detected by single-scan TD OCT or SD OCT ( P = 0.002 and P = 0.006, respectively) when the RNFL was not disrupted. Enhanced SD OCT was more sensitive in detecting the RNFL defects that were not disrupted compared with single-scan TD OCT ( P &lt;0.0001) or SD OCT ( P &lt;0.0001). Enhanced SD OCT had better sensitivity and specificity for detecting glaucoma compared with single-scan TD OCT or SD OCT (sensitivity, P = 0.006 and P = 0.001; specificity, P = 0.001 and P = 0.004, respectively). Conclusions These results suggest that speckle-noise reduction can improve the detection of photographic RNFL defects in which cpRNFL reflectivity on OCT images is not disrupted. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.</description><identifier>ISSN: 0161-6420</identifier><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2010.10.025</identifier><identifier>PMID: 21514958</identifier><identifier>CODEN: OPHTDG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Disease Progression ; Female ; Glaucoma and intraocular pressure ; Glaucoma, Open-Angle - complications ; Glaucoma, Open-Angle - diagnosis ; Glaucoma, Open-Angle - physiopathology ; Humans ; Intraocular Pressure ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Ophthalmology ; Retinal Diseases - diagnosis ; Retinal Diseases - etiology ; Retinal Ganglion Cells - pathology ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Optical Coherence - methods</subject><ispartof>Ophthalmology (Rochester, Minn.), 2011-06, Vol.118 (6), p.1038-1048</ispartof><rights>American Academy of Ophthalmology</rights><rights>2011 American Academy of Ophthalmology</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-84351559498ffdd9ec06400fee3aae1b4180c51477930981a402a19a0cb41d0c3</citedby><cites>FETCH-LOGICAL-c558t-84351559498ffdd9ec06400fee3aae1b4180c51477930981a402a19a0cb41d0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0161642010011012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24211939$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21514958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nukada, Masayuki, MD</creatorcontrib><creatorcontrib>Hangai, Masanori, MD</creatorcontrib><creatorcontrib>Mori, Satoshi, MD</creatorcontrib><creatorcontrib>Nakano, Noriko, MD</creatorcontrib><creatorcontrib>Nakanishi, Hideo, MD</creatorcontrib><creatorcontrib>Ohashi-Ikeda, Hanako, MD</creatorcontrib><creatorcontrib>Nonaka, Atsushi, MD</creatorcontrib><creatorcontrib>Yoshimura, Nagahisa, MD</creatorcontrib><title>Detection of Localized Retinal Nerve Fiber Layer Defects in Glaucoma Using Enhanced Spectral-Domain Optical Coherence Tomography</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>Objective To compare retinal nerve fiber layer (RNFL) defects on fundus photographs with circumpapillary RNFL (cpRNFL) thinning or disruption on images obtained by speckle-noise–reduced spectral-domain optical coherence tomography (enhanced SD OCT), single-scan SD OCT, and single-scan time-domain OCT (TD OCT). Design Retrospective, comparative case series. Participants Forty-four eyes of 44 patients with open-angle glaucoma with localized, wedge-shaped RNFL defects on red-free photographs and 35 normal eyes of 35 volunteers. Methods Cross-sectional images of the cpRNFL and cpRNFL thinning, compared with the confidence interval limit of the normative database where the RNFL defect was photographically identified, were compared between the 3 types of OCT instruments: enhanced SD OCT (SD OCT with eye tracking and averaging of 16 images at the same location to reduce speckle noise; Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany), single-scan SD OCT (RTVue-100; Optovue, Fremont, CA), and single-scan TD OCT (Stratus; Carl Zeiss-Meditec, Dublin, CA). Main Outcome Measures Cross-sectional images of localized RNFL defects on red-free fundus photographs, sensitivity for detecting the photographic RNFL defect, and sensitivity and specificity for detecting glaucoma as having at least 1 abnormally thinned sector on the cpRNFL thickness map on OCT. Results Among the 44 eyes with glaucoma, 65 RNFL defects were identified on red-free fundus photographs. The cpRNFL boundaries were clearer on enhanced SD OCT images than on single-scan SD OCT or TD OCT images, particularly in regions corresponding to the RNFL defects. Enhanced SD OCT revealed various degrees of cpRNFL thinning, and disruption of cpRNFL reflectivity was seen in the same location as the photographic RNFL defect for 23 (35.4%) of the 65 RNFL defects. The RNFL defects were significantly less likely to be detected by single-scan TD OCT or SD OCT ( P = 0.002 and P = 0.006, respectively) when the RNFL was not disrupted. Enhanced SD OCT was more sensitive in detecting the RNFL defects that were not disrupted compared with single-scan TD OCT ( P &lt;0.0001) or SD OCT ( P &lt;0.0001). Enhanced SD OCT had better sensitivity and specificity for detecting glaucoma compared with single-scan TD OCT or SD OCT (sensitivity, P = 0.006 and P = 0.001; specificity, P = 0.001 and P = 0.004, respectively). Conclusions These results suggest that speckle-noise reduction can improve the detection of photographic RNFL defects in which cpRNFL reflectivity on OCT images is not disrupted. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glaucoma and intraocular pressure</subject><subject>Glaucoma, Open-Angle - complications</subject><subject>Glaucoma, Open-Angle - diagnosis</subject><subject>Glaucoma, Open-Angle - physiopathology</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Ophthalmology</subject><subject>Retinal Diseases - diagnosis</subject><subject>Retinal Diseases - etiology</subject><subject>Retinal Ganglion Cells - pathology</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, Optical Coherence - methods</subject><issn>0161-6420</issn><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksFu1DAQQCMEokvhDxDyBfWUZZzY2fiChHbbgrSiEm3PlteZNF6SONhJpeXEpzNhF5C4cLElz5ux_WaS5DWHJQdevNsv_dCMjVlm8OtoCZl8kiy4FCoVK54_TRaE8bQQGZwlL2LcA0BR5OJ5cpZxyYWS5SL5scER7eh8z3zNtt6a1n3Hin3B0fWmZZ8xPCK7cjsMbGsOtG6wpoTIXM-uWzNZ3xl2H13_wC77xvSWkm8HIoJp0w0FibsZRkeF2do3GJAQduc7_xDM0BxeJs9q00Z8ddrPk_ury7v1x3R7c_1p_WGbWinLMS1FLrmUSqiyrqtKoYVCANSIuTHId4KXYOlTq5XKQZXcCMgMVwYshSqw-Xlycaw7BP9twjjqzkWLbWt69FPU5QqkBJ4XRIojaYOPMWCth-A6Ew6ag57V670-qtez-vmU1FPam9MF067D6k_Sb9cEvD0BJpKNOpAsF_9yIuNc5Yq490cOScejw6CjdbO1ygXyqivv_veSfwvY1vVzB77iAePeT4FaGzXXMdOgb-cxmaeEA3CqmuU_AeRwuIQ</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Nukada, Masayuki, MD</creator><creator>Hangai, Masanori, MD</creator><creator>Mori, Satoshi, MD</creator><creator>Nakano, Noriko, MD</creator><creator>Nakanishi, Hideo, MD</creator><creator>Ohashi-Ikeda, Hanako, MD</creator><creator>Nonaka, Atsushi, MD</creator><creator>Yoshimura, Nagahisa, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Detection of Localized Retinal Nerve Fiber Layer Defects in Glaucoma Using Enhanced Spectral-Domain Optical Coherence Tomography</title><author>Nukada, Masayuki, MD ; Hangai, Masanori, MD ; Mori, Satoshi, MD ; Nakano, Noriko, MD ; Nakanishi, Hideo, MD ; Ohashi-Ikeda, Hanako, MD ; Nonaka, Atsushi, MD ; Yoshimura, Nagahisa, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-84351559498ffdd9ec06400fee3aae1b4180c51477930981a402a19a0cb41d0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glaucoma and intraocular pressure</topic><topic>Glaucoma, Open-Angle - complications</topic><topic>Glaucoma, Open-Angle - diagnosis</topic><topic>Glaucoma, Open-Angle - physiopathology</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Ophthalmology</topic><topic>Retinal Diseases - diagnosis</topic><topic>Retinal Diseases - etiology</topic><topic>Retinal Ganglion Cells - pathology</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, Optical Coherence - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nukada, Masayuki, MD</creatorcontrib><creatorcontrib>Hangai, Masanori, MD</creatorcontrib><creatorcontrib>Mori, Satoshi, MD</creatorcontrib><creatorcontrib>Nakano, Noriko, MD</creatorcontrib><creatorcontrib>Nakanishi, Hideo, MD</creatorcontrib><creatorcontrib>Ohashi-Ikeda, Hanako, MD</creatorcontrib><creatorcontrib>Nonaka, Atsushi, MD</creatorcontrib><creatorcontrib>Yoshimura, Nagahisa, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nukada, Masayuki, MD</au><au>Hangai, Masanori, MD</au><au>Mori, Satoshi, MD</au><au>Nakano, Noriko, MD</au><au>Nakanishi, Hideo, MD</au><au>Ohashi-Ikeda, Hanako, MD</au><au>Nonaka, Atsushi, MD</au><au>Yoshimura, Nagahisa, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of Localized Retinal Nerve Fiber Layer Defects in Glaucoma Using Enhanced Spectral-Domain Optical Coherence Tomography</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>118</volume><issue>6</issue><spage>1038</spage><epage>1048</epage><pages>1038-1048</pages><issn>0161-6420</issn><eissn>1549-4713</eissn><coden>OPHTDG</coden><abstract>Objective To compare retinal nerve fiber layer (RNFL) defects on fundus photographs with circumpapillary RNFL (cpRNFL) thinning or disruption on images obtained by speckle-noise–reduced spectral-domain optical coherence tomography (enhanced SD OCT), single-scan SD OCT, and single-scan time-domain OCT (TD OCT). Design Retrospective, comparative case series. Participants Forty-four eyes of 44 patients with open-angle glaucoma with localized, wedge-shaped RNFL defects on red-free photographs and 35 normal eyes of 35 volunteers. Methods Cross-sectional images of the cpRNFL and cpRNFL thinning, compared with the confidence interval limit of the normative database where the RNFL defect was photographically identified, were compared between the 3 types of OCT instruments: enhanced SD OCT (SD OCT with eye tracking and averaging of 16 images at the same location to reduce speckle noise; Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany), single-scan SD OCT (RTVue-100; Optovue, Fremont, CA), and single-scan TD OCT (Stratus; Carl Zeiss-Meditec, Dublin, CA). Main Outcome Measures Cross-sectional images of localized RNFL defects on red-free fundus photographs, sensitivity for detecting the photographic RNFL defect, and sensitivity and specificity for detecting glaucoma as having at least 1 abnormally thinned sector on the cpRNFL thickness map on OCT. Results Among the 44 eyes with glaucoma, 65 RNFL defects were identified on red-free fundus photographs. The cpRNFL boundaries were clearer on enhanced SD OCT images than on single-scan SD OCT or TD OCT images, particularly in regions corresponding to the RNFL defects. Enhanced SD OCT revealed various degrees of cpRNFL thinning, and disruption of cpRNFL reflectivity was seen in the same location as the photographic RNFL defect for 23 (35.4%) of the 65 RNFL defects. The RNFL defects were significantly less likely to be detected by single-scan TD OCT or SD OCT ( P = 0.002 and P = 0.006, respectively) when the RNFL was not disrupted. Enhanced SD OCT was more sensitive in detecting the RNFL defects that were not disrupted compared with single-scan TD OCT ( P &lt;0.0001) or SD OCT ( P &lt;0.0001). Enhanced SD OCT had better sensitivity and specificity for detecting glaucoma compared with single-scan TD OCT or SD OCT (sensitivity, P = 0.006 and P = 0.001; specificity, P = 0.001 and P = 0.004, respectively). Conclusions These results suggest that speckle-noise reduction can improve the detection of photographic RNFL defects in which cpRNFL reflectivity on OCT images is not disrupted. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21514958</pmid><doi>10.1016/j.ophtha.2010.10.025</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Biological and medical sciences
Disease Progression
Female
Glaucoma and intraocular pressure
Glaucoma, Open-Angle - complications
Glaucoma, Open-Angle - diagnosis
Glaucoma, Open-Angle - physiopathology
Humans
Intraocular Pressure
Male
Medical sciences
Middle Aged
Miscellaneous
Ophthalmology
Retinal Diseases - diagnosis
Retinal Diseases - etiology
Retinal Ganglion Cells - pathology
Retrospective Studies
Sensitivity and Specificity
Tomography, Optical Coherence - methods
title Detection of Localized Retinal Nerve Fiber Layer Defects in Glaucoma Using Enhanced Spectral-Domain Optical Coherence Tomography
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