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Comparison Between Deviation Map Algorithm and Peripapillary Retinal Nerve Fiber Layer Measurements Using Cirrus HD-OCT in the Detection of Localized Glaucomatous Visual Field Defects

Kang, Sung Yong MD*; Sung, Kyung Rim MD; Na, Jung Hwa MD; Choi, Eun Hee BS; Cho, Jung Woo MD§; Cheon, Mi Hyun MD; Kim, Kyung Hoon BS; Kook, Michael S. MD

doi: 10.1097/IJG.0b013e3182127ab1
Original Studies
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Purpose To compare the capability of the deviation map algorithm and peripapillary retinal nerve fiber layer (pRNFL) thickness measurements, both determined using Cirrus spectral domain optical coherence tomography (Carl Zeiss Meditec Inc., Dublin, CA), in discrimination between healthy and glaucomatous eyes.

Methods This cross-sectional comparative prospective study included 54 patients with glaucoma with localized visual field (VF) defects confined to 1 hemifield and 54 normal controls. Mean pRNFL thickness corresponding to localized VF defect was calculated. A deviation Score (DS) was assigned by customized Image J software (Http://www.rsb.info.hih.gov/ij/18) calculating the number of abnormal superpixels in the deviation maps corresponding to localized VF defect. Correlations between DS and mean pRNFL thickness, and VF parameters were obtained. The areas under receiver operating characteristic curves of the DS and mean pRNFL thickness used for discriminating between controls and glaucomatous eyes were compared.

Results DS and the average pRNFL thickness measurements showed a strong correlation (R, −0.844, P<0.0001). There were also significant correlations between DS, mean deviation (MD), and pattern standard deviation (R, −0.678, 0.699, respectively). The areas under receiver operating characteristic curves of the mean pRNFL thickness (0.892) and DS (0.958) differed significantly (P=0.0051). The sensitivities at 80%, 90%, and 95% specificities were 94.4%, 90.6%, and 88.6%, respectively, for DS and 74.5%, 58.8%, and 47.3%, for mean pRNFL thickness.

Conclusions The deviation map algorithm showed a superior capability for detection of localized glaucomatous VF defects when compared with traditional pRNFL thickness measurements. There were statistically significant correlations between the deviation map algorithm and VF indices.

*Balgensesang Opthalmology Clinic

Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine

Department of Biostatistics, Yonsei University College of Medicine

§Kong Eye Clinic, Seoul, Korea

Disclosure: The authors declare no conflict of interest.

Reprints: Michael S. Kook, MD, Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Pungnap-dong, Songpa-gu, Seoul, Korea (e-mail: mskook@amc.seoul.kr).

Received August 30, 2010

Accepted January 26, 2011

© 2012 Lippincott Williams & Wilkins, Inc.