Combining Structural and Vascular Parameters to Discriminate Among Glaucoma Patients, Glaucoma Suspects, and Healthy Subjects.

Abstract

Purpose:

Compare the ability of peripapillary and macular structural parameters, vascular parameters, and their integration to discriminate among glaucoma, suspected glaucoma (GS), and healthy controls (HCs).

Methods:

In this study, 196 eyes of 119 patients with glaucoma (n = 81), patients with GS (n = 48), and HCs (n = 67) underwent optical coherence tomography (OCT) and OCT angiography to measure peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell-inner plexiform layer (mGCIPL) thicknesses, radial peripapillary capillary perfusion density (RPC-PD), and macular GCIPL perfusion density (GCIPL-PD). Parameters were integrated regionally with logistic regression and globally with machine learning algorithms. Diagnostic performances were evaluated with area under the receiver operating characteristic (AUROC) curves.

Results:

Patients with glaucoma had mild to moderate damage (median, -3.3 dB; interquartile range, -6.5 to -1.4). In discriminating between patients with glaucoma and the HCs, pRNFL thickness had higher AUROC curve values than RPC-PD for average (0.87 vs. 0.62; P < 0.001), superior (0.86 vs. 0.54; P < 0.001), inferior (0.90 vs. 0.71; P < 0.001), and temporal (0.65 vs. 0.51; P = 0.02) quadrants. mGCIPL thickness had higher AUROC curve values than GCIPL-PD for average (0.84 vs. 0.68; P < 0.001), superotemporal (0.76 vs. 0.65; P = 0.016), superior (0.72 vs. 0.57; P = 0.004), superonasal (0.70 vs. 0.56; P = 0.01), inferotemporal (0.90 vs. 0.72; P < 0.001), inferior (0.87 vs. 0.69; P < 0.001), and inferonasal (0.78 vs. 0.65, P = 0.012) sectors. All structural multisector indices had higher diagnostic ability than vascular ones (P < 0.001). Combined structural-vascular indices did not outperform structural indices. Similar results were found to discriminate glaucoma from GS.

Conclusions:

Combining structural and vascular parameters in a structural-vascular index does not improve diagnostic ability over structural parameters alone.

Translational Relevance:

OCT angiography does not add additional benefit to structural OCT in early to moderate glaucoma diagnosis.

• Authors: Alessandro Rabiolo, Federico Fantaguzzi, Riccardo Sacconi, Francesco Gelormini, Enrico Borrelli, Giacinto Triolo, Paolo Bettin, Andrew I McNaught, Joseph Caprioli, Giuseppe Querques, Francesco Bandello
• Journal: Translational vision science & technology (Transl Vis Sci Technol) Vol. 10 Issue 14 Pg. 20 (12 01 2021) ISSN: 2164-2591 [Electronic] United States
• PMID: 34928324 (Publication Type: Journal Article)

Topics

• Glaucoma (diagnostic imaging)
• Healthy Volunteers
• Humans
• Nerve Fibers
• Ocular Hypertension
• Retinal Ganglion Cells
• Tomography, Optical Coherence