Spectral-Domain Optical Coherence Tomography and Scanning Laser Polarimetry in Glaucoma Diagnosis

Purpose: To evaluate glaucoma diagnostic capability of the retinal nerve fiber layer (RNFL) imaging by spectral-domain optical coherence tomography (Cirrus OCT) and scanning laser polarimetry (GDx VCC). Methods: We imaged 88 glaucomatous and 77 healthy eyes using both devices. Areas under the receiver-operating characteristic curves (area under the curves, AUCs) and sensitivities at fixed specificities of average, superior, and inferior RNFL thickness were compared. Likelihood ratios (LRs) and diagnostic agreement based on normative classifications yielded by both devices were determined. Results: The best performing parameter was the nerve fiber indicator (NFI) in GDx VCC and inferior RNFL thickness in Cirrus OCT (AUC = 0.912, 0.961, P = 0.045). The AUCs of the Cirrus OCT were significantly higher than those of GDx VCC in all parameters. Most of the parameters in Cirrus OCT were more sensitive than GDx VCC in the detection of glaucoma at fixed specificity values. Cirrus OCT had an infinite LR with abnormal classification results in both average and superior RNFL thickness. There was good agreement between the two instruments with respect to abnormal classifications (kappa, 0.611-0.766) Conclusion: Both Cirrus OCT and GDx VCC RNFL measurements showed good glaucoma diagnostic capabilities. Cirrus OCT showed higher sensitivities than GDx VCC. Jpn J Ophthalmol 2010;54:544-549 (C) Japanese Ophthalmological Society 2010