PMID- 17981334
OWN - NLM
STAT- MEDLINE
DCOM- 20080612
LR  - 20220408
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Print)
IS  - 0161-6420 (Linking)
VI  - 115
IP  - 6
DP  - 2008 Jun
TI  - Mapping of macular substructures with optical coherence tomography for glaucoma 
      diagnosis.
PG  - 949-56
AB  - PURPOSE: To use optical coherence tomography (OCT) to identify the specific 
      retinal layers and macular regions damaged in glaucoma. DESIGN: Observational 
      cross-sectional study. PARTICIPANTS: One hundred forty-nine participants in the 
      Advanced Imaging for Glaucoma Study, divided into 3 groups: normal (N) perimetric 
      glaucoma (PG), and glaucoma suspect and preperimetric glaucoma (GSPPG) with 44, 
      73, and 29 persons, respectively. METHODS: The Zeiss Stratus OCT system (Carl 
      Zeiss Meditec, Inc., Dublin, CA) was used to map the macula over a 6-mm diameter 
      and to scan the circumpapillary nerve fiber layer (cpNFL). The macular OCT images 
      were exported for automatic segmentation using software developed by the authors. 
      The thickness of the macular nerve fiber layer (mNFL), ganglion cell layer 
      (mGCL), inner plexiform layer (mIPL), inner nuclear layer (mINL), outer retinal 
      layer (mORL), and total retinal thickness were measured. Thickness measurements 
      of GSPPG and PG eyes were compared with those of N eyes. The ability to 
      differentiate between GSPPG and PG eyes against N eyes was assessed by fractional 
      loss, standardized deviation, and the area under the receiver operating 
      characteristic curve. MAIN OUTCOME MEASURES: Area-weighted average thicknesses of 
      retinal sublayers in the macula. RESULTS: The mNFL, mGCL, mIPL, and mINL were 
      significantly (P<0.001) thinner in both the GSPPG and PG eyes than in the N eyes. 
      In PG eyes, mNFL, mGCL, and mIPL thinning was most severe (approximately 20%), 
      mINL thinning was intermediate (7%), and mORL thinning was minimal (3%). The 
      repeatability (coefficient of variation and intraclass correlation) of thickness 
      measurements was improved by combining the mNFL, mGCL, and mIPL measurements as 
      the inner retinal layer (mIRL). The mIRL was the best macular parameter for 
      glaucoma diagnosis and had discriminant power comparable with that of the cpNFL. 
      The fractional loss of mIRL thickness was most severe in the inferior perifoveal 
      region for both the PG and GSPPG groups. CONCLUSIONS: Glaucoma leads to thinning 
      of the mNFL, mGCL, mIPL, and mINL, even before detectable visual field changes 
      occur. A combination of the 3 innermost layers seems to provide optimal glaucoma 
      detection. Increasing the sampling of peripheral macula with a new OCT scan 
      pattern may improve glaucoma diagnosis further.
FAU - Tan, Ou
AU  - Tan O
AD  - Doheny Eye Institute, University of Southern California, Los Angeles, California 
      90033, USA.
FAU - Li, Gisele
AU  - Li G
FAU - Lu, Ake Tzu-Hui
AU  - Lu AT
FAU - Varma, Rohit
AU  - Varma R
FAU - Huang, David
AU  - Huang D
CN  - Advanced Imaging for Glaucoma Study Group
LA  - eng
GR  - P30 EY03040/EY/NEI NIH HHS/United States
GR  - R01 EY013516,/EY/NEI NIH HHS/United States
GR  - P30 EY003040/EY/NEI NIH HHS/United States
GR  - R01 EY013516-01A1/EY/NEI NIH HHS/United States
GR  - R01 EY013516/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20071105
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
MH  - Algorithms
MH  - Cross-Sectional Studies
MH  - *Diagnostic Techniques, Ophthalmological
MH  - Female
MH  - Glaucoma, Open-Angle/*diagnosis
MH  - Humans
MH  - Intraocular Pressure
MH  - Male
MH  - Middle Aged
MH  - Nerve Fibers/pathology
MH  - Ocular Hypertension/diagnosis
MH  - ROC Curve
MH  - Retina/*pathology
MH  - Retinal Bipolar Cells/pathology
MH  - Retinal Ganglion Cells/pathology
MH  - Retinal Horizontal Cells/pathology
MH  - Tomography, Optical Coherence/*methods
MH  - Visual Field Tests
PMC - PMC2692598
MID - NIHMS102193
EDAT- 2007/11/06 09:00
MHDA- 2008/06/13 09:00
PMCR- 2009/06/08
CRDT- 2007/11/06 09:00
PHST- 2007/02/15 00:00 [received]
PHST- 2007/07/27 00:00 [revised]
PHST- 2007/08/06 00:00 [accepted]
PHST- 2007/11/06 09:00 [pubmed]
PHST- 2008/06/13 09:00 [medline]
PHST- 2007/11/06 09:00 [entrez]
PHST- 2009/06/08 00:00 [pmc-release]
AID - S0161-6420(07)00878-0 [pii]
AID - 10.1016/j.ophtha.2007.08.011 [doi]
PST - ppublish
SO  - Ophthalmology. 2008 Jun;115(6):949-56. doi: 10.1016/j.ophtha.2007.08.011. Epub 
      2007 Nov 5.