Clinical Study
Spectral Domain Optical Coherence Tomography Assessment of
Macular and Optic Nerve Alterations in Patients with Glaucoma
and Correlation with Visual Field Index
Alessio Martucci ,
1
Nicola Toschi ,
2,3,4
Massimo Cesareo,
1
Clarissa Giannini,
1
Giulio Pocobelli,
1
Francesco Garaci ,
2
Raffaele Mancino,
1
and Carlo Nucci
1
1
Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
2
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
3
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
4
Harvard Medical School, Boston, MA, USA
Correspondence should be addressed to Carlo Nucci; nucci@med.uniroma2.it
Received 4 July 2018; Accepted 3 September 2018; Published 8 October 2018
Academic Editor: Angelo Balestrazzi
Copyright © 2018 Alessio Martucci et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction. To evaluate the sectorial thickness of single retinal layers and optic nerve using spectral domain optic coherence
tomography (SD-OCT) and highlight the parameters with the best diagnostic accuracy in distinguishing between normal and
glaucoma subjects at different stages of the disease. Material and Methods. For this cross-sectional study, 25 glaucomatous (49 eyes)
and 18 age-matched healthy subjects (35 eyes) underwent a complete ophthalmologic examination including visual field testing.
Sectorial thickness values of each retinal layer and of the optic nerve were measured using SD-OCT Glaucoma Module Premium
Edition (GMPE) software. Each parameter was compared between the groups, and the layers and sectors with the best area under the
receiver operating characteristic curve (AUC) were identified. Correlation of visual field index with the most relevant structural
parameters was also evaluated. Results and Discussion. All subjects were grouped according to stage as follows: Controls (CTRL);
Early Stage Group (EG) (Stage 1 + Stage 2); Advanced Stage Group (AG) (Stage 3 + Stage 4 + Stage 5). mGCL TI, mGCL TO, mIPL
TO, mean mGCL, cpRNFLt NS, and cpRNFLt TI showed the best results in terms of AUC according classification proposed by Swets
(0.9 < AUC < 1.0). ese parameters also showed significantly different values among group when CTRL vs EG, CTRL vs AG, and EG
vs AG were compared. SD-OCT examination showed significant sectorial thickness differences in most of the macular layers when
glaucomatous patients at different stages of the disease were compared each other and to the controls.
1. Introduction
Primary open-angle glaucoma, a leading cause of blindness
in the world, is an optic neuropathy characterized by the
death of ganglion cells of the retina, which is associated
with the loss of axons that make up the optic nerve. ese
ultrastructural alterations gradually progress becoming
clinically evident as an increased excavation of the optic
discandthepresenceofspecificvisualfield(VF)defects[1].
Diagnosing and monitoring disease progression is there-
fore essential for the management of patients with glau-
coma. Given that a significant structural loss usually
precedes detectable function loss [2], technologies and
strategies able to quantify glaucomatous changes at an
early stage have the potential to impact prognosis and
hence influence quality of life [3]. In this context, spectral
domain-optical coherence tomography (SD-OCT) pro-
vides a tool for macular segmentation and thickness
evaluation of individual retinal layers as well as retinal
nerve fiber layer thickness (RNFLt) and Bruch’s membrane
opening (BMO)-minimum rim width (MRW) assessment.
e patented Anatomic Position System (APS) creates an
anatomic map of each patient’s eye using the center of the
fovea and the center of BMO as landmarks. In turn, this
allows accurate localization and hence highly sensitive
assessment of structural changes.
Hindawi
Journal of Ophthalmology
Volume 2018, Article ID 6581846, 9 pages
https://doi.org/10.1155/2018/6581846