PMID- 24393348
OWN - NLM
STAT- MEDLINE
DCOM- 20140604
LR  - 20220316
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 121
IP  - 4
DP  - 2014 Apr
TI  - Diagnostic performance of optical coherence tomography ganglion cell--inner 
      plexiform layer thickness measurements in early glaucoma.
PG  - 849-54
LID - S0161-6420(13)01051-8 [pii]
LID - 10.1016/j.ophtha.2013.10.044 [doi]
AB  - PURPOSE: To evaluate the glaucoma diagnostic performance of ganglion cell 
      inner-plexiform layer (GCIPL) parameters used individually and in combination 
      with retinal nerve fiber layer (RNFL) or optic nerve head (ONH) parameters 
      measured with Cirrus HD-OCT (Carl Zeiss Meditec, Inc, Dublin, CA). DESIGN: 
      Prospective cross-sectional study. PARTICIPANTS: Fifty patients with early 
      perimetric glaucoma and 49 age-matched healthy subjects. METHODS: Three 
      peripapillary RNFL and 3 macular GCIPL scans were obtained in 1 eye of each 
      participant. A patient was considered glaucomatous if at least 2 of the 3 RNFL or 
      GCIPL scans had the average or at least 1 sector measurement flagged at 1% to 5% 
      or less than 1%. The diagnostic performance was determined for each GCIPL, RNFL, 
      and ONH parameter as well as for binary or-logic and and-logic combinations of 
      GCIPL with RNFL or ONH parameters. MAIN OUTCOME MEASURES: Sensitivity, 
      specificity, positive likelihood ratio (PLR), and negative likelihood ratio 
      (NLR). RESULTS: Among GCIPL parameters, the minimum had the best diagnostic 
      performance (sensitivity, 82.0%; specificity, 87.8%; PLR, 6.69; and NLR, 0.21). 
      Inferior quadrant was the best RNFL parameter (sensitivity, 74%; specificity, 
      95.9%; PLR, 18.13; and NLR, 0.27), as was rim area (sensitivity, 68%; 
      specificity, 98%; PLR, 33.3; and NLR, 0.33) among ONH parameters. The or-logic 
      combination of minimum GCIPL and average RNFL provided the overall best 
      diagnostic performance (sensitivity, 94%; specificity, 85.7%; PRL, 6.58; and NLR, 
      0.07) as compared with the best RNFL, best ONH, and best and-logic combination 
      (minimum GCIPL and inferior quadrant RNFL; sensitivity, 64%; specificity, 100%; 
      PLR, infinity; and NPR, 0.36). CONCLUSIONS: The binary or-logic combination of 
      minimum GCIPL and average RNFL or rim area provides better diagnostic 
      performances than those of and-logic combinations or best single GCIPL, RNFL, or 
      ONH parameters. This finding may be clinically valuable for the diagnosis of 
      early glaucoma.
CI  - Copyright (c) 2014 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Mwanza, Jean-Claude
AU  - Mwanza JC
AD  - Department of Ophthalmology, University of North Carolina School of Medicine, 
      Chapel Hill, North Carolina.
FAU - Budenz, Donald L
AU  - Budenz DL
AD  - Department of Ophthalmology, University of North Carolina School of Medicine, 
      Chapel Hill, North Carolina. Electronic address: donald_budenz@med.unc.edu.
FAU - Godfrey, David G
AU  - Godfrey DG
AD  - Glaucoma Associates of Texas, Dallas, Texas.
FAU - Neelakantan, Arvind
AU  - Neelakantan A
AD  - Glaucoma Associates of Texas, Dallas, Texas.
FAU - Sayyad, Fouad E
AU  - Sayyad FE
AD  - Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 
      Miami, Florida.
FAU - Chang, Robert T
AU  - Chang RT
AD  - Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, 
      California.
FAU - Lee, Richard K
AU  - Lee RK
AD  - Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 
      Miami, Florida.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140103
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2015 Feb;122(2):e13-4. PMID: 25618429
CIN - Ophthalmology. 2015 Feb;122(2):e14-5. PMID: 25618430
MH  - Aged
MH  - Aged, 80 and over
MH  - Axons/*pathology
MH  - Cross-Sectional Studies
MH  - *Diagnostic Techniques, Ophthalmological
MH  - Female
MH  - Glaucoma/*diagnosis
MH  - Humans
MH  - Intraocular Pressure
MH  - Likelihood Functions
MH  - Male
MH  - Middle Aged
MH  - Optic Disk/*pathology
MH  - Optic Nerve Diseases/*diagnosis
MH  - Prospective Studies
MH  - Retinal Ganglion Cells/*pathology
MH  - Sensitivity and Specificity
MH  - *Tomography, Optical Coherence
MH  - Visual Field Tests
MH  - Visual Fields/physiology
EDAT- 2014/01/08 06:00
MHDA- 2014/06/05 06:00
CRDT- 2014/01/08 06:00
PHST- 2013/08/09 00:00 [received]
PHST- 2013/10/27 00:00 [revised]
PHST- 2013/10/28 00:00 [accepted]
PHST- 2014/01/08 06:00 [entrez]
PHST- 2014/01/08 06:00 [pubmed]
PHST- 2014/06/05 06:00 [medline]
AID - S0161-6420(13)01051-8 [pii]
AID - 10.1016/j.ophtha.2013.10.044 [doi]
PST - ppublish
SO  - Ophthalmology. 2014 Apr;121(4):849-54. doi: 10.1016/j.ophtha.2013.10.044. Epub 
      2014 Jan 3.