Sensitivity and specificity of the StratusOCT for perimetric glaucoma

Purpose: To determine the sensitivity and specificity of measurements of the retinal nerve fiber layer (RNFL) using the StratusOCT in glaucoma subjects with visual field (VF) defects. Design: Prospective cross-sectional study. Participants: One hundred nine normal and 63 glaucoma subjects. Testing: Fast RNFL scans were performed in one eye of each patient using the StratusOCT. Main Outcome Measures: Sensitivity and specificity of different optical coherence tomography (OCT) criteria for identifying glaucoma subjects with glaucomatous VF defects. Secondary Outcome Measures: Areas under the receiver operating characteristic curves (AROCs) for various OCT parameters. Results: Severity of VF defects in the glaucoma group was distributed between mild (18 subjects), moderate (21 subjects), and severe (24 subjects). The average mean deviation of the glaucoma fields was -8.4 decibels (dB), with a standard deviation of 6.0 dB and a range from -0.14 to -28.0 dB. The sensitivity and specificity using a criterion of average RNFL thickness abnormal at the <5% level were 84% and 98%, respectively. The sensitivity and specificity using a criterion of average RNFL thickness abnormal at the <1% level were 68% and 100%. The sensitivity and specificity of using a criterion of greater than or equal to1 quadrants abnormal at the <5% level were 89% and 95%. The sensitivity and specificity of using a criterion of greater than or equal to1 quadrants abnormal at the <1% level were 83% and 100%. The sensitivity and specificity of using a criterion of greater than or equal to1 clock hours abnormal at the <5% level were 89% and 92%. The sensitivity and specificity of using a criterion of greater than or equal to1 quadrants abnormal at the <1% level were 83% and 100%. The AROC for mean RNFL thickness was 0.966. Other high AROC values included the superior quadrant (0.952), inferior quadrant (0.971), inferotemporal clock hour at 7-o'clock (right eye) and 5-o'clock (left eye) (0.959), 6-o'clock hour (0.940), superotemporal clock hour at 11-o'clock (right eye) and 1-o'clock (left eye) (0.935), and 12-o'clock hour (0.924). Conclusions: The sensitivity and specificity of RNFL measurements using the new StratusOCT for glaucoma with manifest VF defects are excellent. The best parameters seem to be greater than or equal to1 quadrants abnormal at the less than or equal to5% level or greater than or equal to1 clock hours abnormal at the less than or equal to5% level. Future studies are needed to determine the sensitivity and specificity of this new technology for glaucoma without VF defects. (C) 2005 by the American Academy of Ophthalmology.