Usefulness of Table Parameters of Stratus OCT in Detection of Localized Retinal Nerve Fiber Layer Defects

PURPOSE: To evaluate the usefulness of table parameters of Stratus optical coherence tomography (OCT) in order to detect localized retinal nerve fiber layer (RNFL) defects. METHODS: The present study included 86 glaucoma patients with only localized, wedge-shaped RNFL defects, as determined by red-free RNFL photographs. All subjects were tested fast RNFL scans, using of Stratus OCT. The sensitivity of the clock hour parameter and 11 table parameters of RNFL thickness average analysis were compared. RESULTS: The best parameters in the superior table parameter of the Stratus OCT were Smax, Savg, and Smax/Tavg (sensitivity = 36.7%, 36.7%, 36.7%, respectively). The best parameters in the inferior table parameter of the Stratus OCT were Iavg, Imax, and Imax/Smax (sensitivity = 63.8%, 59.4%, and 50.7%, respectively). However, all were significantly lower than the sensitivity of the clock hour parameter (superior RNFL defect: 60%; inferior RNFL defect: 84.1%). CONCLUSIONS: The usefulness of the table parameters of the Stratus OCT used to detect localized RNFL defects in glaucoma patients is considered low because of its low sensitivity.

Scanning Laser Polarimetry and Optical Coherence Tomography for Detection of Retinal Nerve Fiber Layer Defects

PURPOSE: To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. METHODS: This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. RESULTS: Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. CONCLUSIONS: According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.