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Clinical Use of an Optical Coherence Tomography Linear Discriminant Function for Differentiating Glaucoma From Normal Eyes

Choi, Yun Jeong MD; Jeoung, Jin Wook MD, PhD; Park, Ki Ho MD, PhD; Kim, Dong Myung MD, PhD

doi: 10.1097/IJG.0000000000000210
Online Articles: Original Studies
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Purpose: To determine and validate the diagnostic ability of a linear discriminant function (LDF) based on retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness obtained using high-definition optical coherence tomography (Cirrus HD-OCT) for discriminating between healthy controls and early glaucoma subjects.

Methods: We prospectively selected 214 healthy controls and 152 glaucoma subjects (teaching set) and another independent sample of 86 healthy controls and 71 glaucoma subjects (validating set). Two scans, including 1 macular and 1 peripapillary RNFL scan, were obtained. After calculating the LDF in the teaching set using the binary logistic regression analysis, receiver operating characteristic curves were plotted and compared between the OCT-provided parameters and LDF in the validating set.

Results: The proposed LDF was 16.529−(0.132×superior RNFL)−(0.064×inferior RNFL)+(0.039×12 o’clock RNFL)+(0.038×1 o’clock RNFL)+(0.084×superior GCIPL)−(0.144×minimum GCIPL). The highest area under the receiver operating characteristic (AUROC) curve was obtained for LDF in both sets (AUROC=0.95 and 0.96). In the validating set, the LDF showed significantly higher AUROC than the best RNFL (inferior RNFL=0.91) and GCIPL parameter (minimum GCIPL=0.88). The LDF yielded a sensitivity of 93.0% at a fixed specificity of 85.0%.

Conclusions: The LDF showed better diagnostic ability for differentiating between healthy and early glaucoma subjects than individual OCT parameters. A classification algorithm based on the LDF can be used in the OCT analysis for glaucoma diagnosis.

*Department of Ophthalmology, Seoul National University College of Medicine

Department of Ophthalmology, Seoul National University Hospital, Seoul

Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea

Supported by a grant of the Korea Health technology R&D Project, Ministry of Health & Welfare, Republic of Korea (Grant Number: A121615).

Disclosure: The authors declare no conflict of interest.

Reprints: Jin Wook Jeoung, MD, PhD, Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea (e-mail: neuroprotect@gmail.com).

Received January 27, 2014

Accepted November 27, 2014

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