Diagnostic ability of macular nerve fiber layer thickness measured by swept-source optical coherence tomography in preperimetric glaucoma - Abstract

Sep 29, 2026

Upload by Hazel

Background: Evaluate diagnostic ability of macular retinal nerve fiber layer (mRNFL) thickness in preperimetric glaucoma (PPG). Methods: Prospective study with 83 PPG patients and 83 age- and refractive error-matched controls. PPG defined by localized RNFL defect with glaucomatous optic disc changes and normal visual field. Swept-source OCT quantified cpRNFL, GCL+, and GCL++ (mRNFL=GCL++−GCL+); SD-OCT provided cpRNFL and GCIPL. Results: Most OCT parameters were lower in PPG. Inferotemporal GCL++ showed strongest AUROC (0.904), and mRNFL performance was comparable to best cpRNFL and GCL measures. Conclusion: mRNFL thickness can detect early structural changes in PPG.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

1. INTRODUCTION

2. METHODS

J Chin MedAssoc Original article Diagnostic ability of macular nerve fiber layer thickness measured by swept-source optical coherence tomography in preperimetric glaucoma Shih-Jung Yeha, Yi-Wen Sub, Mei-Ju Chenb,c,* aDepartment of Ophthalmology, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan, ROC; bDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cSchool of Medicine, National Yang Ming Chao Tung University, Taipei, Taiwan, ROC Abstract Background: We evaluated the diagnostic ability of macula retinal nerve fiber layer (mRNFL) thickness in preperimetric glaucoma (PPG) patients. Methods: This prospective study included 83 patients with PPG and 83 age-and refractive error-matched normal control subjects. PPG was defined as a localized RNFL defect corresponding to glaucomatous optic disc changes with a normal visual field test. We used spectral-domain (SD) optical coherence tomography (OCT) to measure the circumpapillary RNFL (cpRNFL) thickness and macular ganglion cell-inner plexiform layer (GCIPL) thickness. Swept-source (SS) OCT was used to measure cpRNFL thickness, macular ganglion cell layer + inner plexiform layer (IPL) thickness (GCL+), and macular ganglion cell layer + IPL+ mRNFL thickness (GCL++) . The mRNFL thickness was defined as GCL++ minus GCL+ . To evaluate the diagnostic power of each parameter, the area under the receiver operating characteristics curve (AUROC) was analyzed to differentiate PPG from the normal groups. Results: Using SD-OCT, all GCIPL parameters and most cpRNFL parameters, except at the nasal and temporal quadrant, were significantly lower in PPG versus normal controls. PPG eyes had significantly smaller values than normal controls for all cpRNFL and GCL parameters measured by SS-OCT, except mRNFL at the superonasal area. The inferotemporal GCL++ had the largest AUROC value (0 .904), followed by inferotemporal GCL+ (0 .882), inferotemporal GCIPL thickness (0 .871), inferior GCL++ (0 .866), inferior cpRNFL thickness by SS-OCT (0 .846), inferior cpRNFL thickness by SD-OCT (0 .841), and inferotemporal mRNFL thickness (0 .840) . The diagnostic performance was comparable between inferotemporal mRNFL thickness and the best measures of GCL (inferotemporal GCL++, p = 0.098) and cpRNFL (inferior cpRNFL thickness by SS-OCT, p = 0.546) . Conclusion: The diagnostic ability of mRNFL thickness was comparable to that of the best measures of cpRNFL and GCL analysis for eyes with PPG. Therefore, mRNFL thickness could be a new parameter to detect early structural changes in PPG. Keywords: Macular nerve fiber layer; Preperimetric glaucoma; Swept-source optical coherence tomography. 1. INTRODUCTION Glaucoma is characterized by the progressive death of retinal ganglion cells (RGCs) and damage to their axons in accordance with related visual field (VF) defects. Previous studies indicate that VF defects may not be clinically observable until 25% to 35% of all RGCs are absent.1–4 Early detection of RGC loss is essential for preperimetric glaucoma (PPG) . PPG presents as glaucomatous optic disc and retinal nerve fiber layer (RNFL) defects with normal VF. Previous studies have demonstrated evidence of early glaucomatous damage in the macula.5 Using spectral-domain optical coherence tomography (SD-OCT), several studies have *Address correspondence. Dr. Mei-Ju Chen, Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: mj_chen@vghtpe.gov.tw](ROC. E-mail address: mj_chen@vghtpe.gov.tw) (M.-J. Chen). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 722-727. Received May 11, 2023; accepted April 4, 2024. doi: 10. 1097/JCMA.0000000000001112 Copyright © 2024, the Chinese Medical Association. This is an open access article u

FAQs

What diagnostic ability did the study evaluate in preperimetric glaucoma (PPG)?

The study evaluated how well macular retinal nerve fiber layer (mRNFL) thickness can differentiate PPG from normal controls, using swept-source OCT measurements and AUROC analysis.

How was PPG defined for participants in this research?

PPG was defined as a localized RNFL defect matching glaucomatous optic disc changes while the visual field test remained normal.

Which OCT-derived parameter showed the highest diagnostic performance?

Inferotemporal GCL++ had the largest AUROC value (0.904), followed by inferotemporal GCL+ (0.882) and inferotemporal GCIPL thickness (0.871).

Sep 29, 2026

Upload by Hazel