Detection of early glaucoma with optical coherence tomography (StratusOCT).

PURPOSE: To evaluate the performance of optical coherence tomography (StratusOCT) for discriminating eyes with early glaucoma from normal eyes.

METHODS: Thirty eyes with established early glaucomatous visual field defects (EGVF group), 30 eyes with evidence of early glaucomatous optic neuropathy with normal standard achromatic perimetry [early glaucoma by disc (EGD)], and 33 age-matched normal eyes with good quality StratusOCT nerve fiber layer (NFL) images were enrolled. Average NFL thickness and NFL thickness at quadrants and sectors, areas under receiver operator characteristic curves, and sensitivities at 80% and 90% specificity were evaluated.

RESULTS: The average (+/-SD) mean deviation in the EGVF group was -3.4 (+/-1.7) dB. Receiver operator characteristic curves showed areas under the curve (AUC) for NFL thickness in the superior quadrant (AUC=0.75+/-0.07) and in the inferior quadrant (AUC=0.94+/-0.03) to be the best StratusOCT parameters for discrimination of normal controls from EGD and EGVF eyes, respectively. The best parameter for detection of EGD eyes at 80% and 90% specificities was NFL thickness at superior quadrant (51% and 36% sensitivities, respectively). The best parameter for detection of EGVF eyes at 80% and 90% specificities was NFL thickness in the inferior quadrant (90% and 87% sensitivities, respectively).

CONCLUSIONS: Optical coherence tomography (StratusOCT) showed good sensitivity and specificity in a group of glaucoma patients with early visual field loss. In patients with normal visual fields in whom the optic disc appeared glaucomatous to glaucoma specialists, half were confirmed to have StratusOCT findings consistent with damage from glaucoma.