11 Glaucoma suspects included individuals with an elevated IOP and/or glaucomatous optic disc appearance but without functional defects detectable with VFT. Glaucomatous eyes had to have elevated untreated IOP of greater than 21 mm Hg, an abnormal optic disc appearance (thinning of the neuroretinal rim, notches, or papillary hemorrhages), or RNFL defects, with a correspondent and reproducible visual field defect as described by Anderson et al. 10 Healthy controls had a normal ONH appearance, an intraocular pressure (IOP) of less than 21 mm Hg, and a normal VFT. Based on clinical examination by two glaucoma specialists (M.P., N.V.A.), patients were classified into three groups: controls, glaucoma suspects, and those with glaucoma. These OCT-based calculators may improve glaucoma diagnosis in clinical care.Īll participants underwent a complete ophthalmic examination, with visual acuity, pachymetry, slit-lamp biomicroscopy of the anterior and posterior segments, Goldmann applanation tonometry, gonioscopy, 24-2 SITA standard visual field testing (VFT) (Humphrey Field Analyzer Carl Zeiss Meditec, Dublin, CA), and RNFL, optic disc, and GCIPL analysis using Cirrus HD-OCT. GDC2 was able to identify approximately 30% more cases than the conventional pRNFL inferior OCT classification in both groups, suggesting a potential role of these composite scores in clinical practice. OCT-based calculators showed an excellent diagnostic performance in glaucomatous eyes. Calibration showed risk underestimation for both groups and calculators, but it was better in GDC2 and in patients with glaucoma. The discriminating ability was not as good for glaucoma suspects, but the GDCs were not inferior to pRNFL (GDC 1 AUC = 0.739 GDC2 = 0.730 inferior pRNFL = 0.760 P = 0.54) and GDC2 was still able to correctly identify up to 30.8% more cases than the conventional OCT classification. Both GDCs obtained the highest discriminative ability in glaucomatous eyes (GDC1 AUC = 0.949 GDC2 = 0.943 vs inferior peripapillary retinal nerve fiber layer = 0.931 P = 0.43).

GDC2 was able to identify 46.9% more suspects and 14.7% more glaucomatous eyes than GDC1. The discrimination (area under the curve ) and calibration (calibration plots) were compared for both calculators and the best OCT parameters. The reference diagnosis was compared against the probability of having glaucoma obtained from two GDCs derived from multivariate logistic regressions using quantitative and qualitative (GDC1) or only quantitative (GDC2) OCT data. Demographics, reliable visual field testing, and macular and optic disc OCT were collected. We conducted a retrospective, consecutive sampling of 76 patients with primary open-angle glaucoma, 107 glaucoma suspects, and 67 controls.

To clinically validate the diagnostic ability of two optical coherence tomography (OCT)-based glaucoma diagnostic calculators (GDCs).

External coherence