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Transl Vis Sci Technol. 2018 Apr 3;7(2):16. doi: 10.1167/tvst.7.2.16. eCollection 2018 Apr.

Validation of the UNC OCT Index for the Diagnosis of Early Glaucoma.

Author information

1
Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
2
Research and Development, Carl Zeiss Meditec, Inc., Dublin, CA, USA.
3
Department of Biostatistics, Yale University, New Haven, CT, USA.
4
Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA.
5
Eye and Vision Research Group, Institute of Health and Community, Plymouth University, UK.
6
School of Optometry, University of California Berkeley, Berkeley, CA, USA.

Abstract

Purpose:

To independently validate the performance of the University of North Carolina Optical Coherence Tomography (UNC OCT) Index in diagnosing and predicting early glaucoma.

Methods:

Data of 118 normal subjects (118 eyes) and 96 subjects (96 eyes) with early glaucoma defined as visual field mean deviation (MD) greater than -4 decibels (dB), aged 40 to 80 years, and who were enrolled in the Full-Threshold Testing Size III, V, VI comparison study were used in this study. CIRRUS OCT average and quadrants' retinal nerve fiber layer (RNFL); optic disc vertical cup-to-disc ratio (VCDR), cup-to-disc area ratio, and rim area; and average, minimum, and six sectoral ganglion cell-inner plexiform layer (GCIPL) measurements were run through the UNC OCT Index algorithm. Area under the receiver operating characteristic curve (AUC) and sensitivities at 95% and 99% specificity were calculated and compared between single parameters and the UNC OCT Index.

Results:

Mean age was 60.1 ± 11.0 years for normal subjects and 66.5 ± 8.1 years for glaucoma patients (P < 0.001). MD was 0.29 ± 1.04 dB and -1.30 ± 1.35 dB in normal and glaucomatous eyes (P < 0.001), respectively. The AUC of the UNC OCT Index was 0.96. The best single metrics when compared to the UNC OCT Index were VCDR (0.93, P = 0.054), average RNFL (0.92, P = 0.014), and minimum GCIPL (0.91, P = 0.009). The sensitivities at 95% and 99% specificity were 85.4% and 76.0% (UNC OCT Index), 71.9% and 62.5% (VCDR, all P < 0.001), 64.6% and 53.1% (average RNFL, all P < 0.001), and 66.7% and 58.3% (minimum GCIPL, all P < 0.001), respectively.

Conclusions:

The findings confirm that the UNC OCT Index may provide improved diagnostic perforce over that of single OCT parameters and may be a good tool for detection of early glaucoma.

Translational Relevance:

The UNC OCT Index algorithm may be incorporated easily into routine clinical practice and be useful for detecting early glaucoma.

KEYWORDS:

UNC OCT Index; early glaucoma; optical coherence tomography

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