Can diagnostic accuracy for early glaucoma be improved in Japanese? A trial with a potential new parameter of the RTVue OCT

Yoshiyuki Kita, Gábor Hollό, Ritsuko Kita


Aim: To evaluate the diagnostic accuracy of the ratio of circumpapillary retinal nerve fiber layer thickness (cpRNFLT) to macular outer retinal thickness (R/O ratio) and the ratio of ganglion cell complex (GCC) thickness to outer retinal thickness (G/O ratio) measured with the RTVue-100 Fourier-domain optical coherence tomograph for detecting early glaucoma in Japanese eyes.

Methods: Forty-seven healthy control, 31 preperimetric and 70 early perimetric glaucoma eyes. We used cpRNFLT and macular retinal thickness measurements to calculate new ratio parameters, and to compare their diagnostic accuracy to those of the manufacturer-provided parameters of the RTVue-100. The ability of each parameter to diagnose glaucoma was examined by comparing the area under the receiver-operating characteristics curve (AUROC).

Results: AUROC values for the healthy vs. preperimetric glaucoma comparison were 0.842, 0.859, and 0.925 for average cpRNFLT, average R/O ratio, and average G/O ratio, respectively. For the healthy vs. early perimetric glaucoma comparison the AUROC values were 0.927, 0.933, and 0.979 for cpRNFLT, R/O ratio, and G/O ratio, respectively. Diagnostic accuracy of the R/O ratio and cpRNFLT did not differ significantly (P > 0.05). Diagnostic accuracy for the G/O ratio was significantly greater than the cpRNFLT in early glaucoma (P < 0.05).

Conclusions: Use of the G/O ratio is recommended for the detection of early glaucoma in Japanese eyes.


ganglion cell complex, outer retinal thickness, ratio, preperimetric glaucoma, retinal nerve fiber layer thickness

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