LAUSR

PURPOSE To evaluate the ability of topographically correspondent (TC) minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) criteria to detect optical coherence tomography (OCT) structural abnormality in glaucoma (GL) and glaucoma suspect (GLS) eyes. DESIGN Retrospective cross-sectional study. METHODS 196 GL, 150 GLS eyes and 303 Heathy eyes underwent PRNFL and 24 radial optic nerve head OCT imaging and manual correction of the internal limiting membrane, Bruch's membrane opening (BMO) and outer pRNFL segmentations. MRW and pRNFLT were quantified in six Garway-Heath (GH) or twelve 30° (clock-hour) sectors. OCT abnormality for each parameter was defined to be < the 5th percentile of the Healthy eye distribution. OCT abnormality for individual eyes was defined using global, sectoral and combined-parameter criteria that achieved ≥ 95% specificity in the Healthy eyes. TC combination criteria required the sectoral location of MRW and pRNFLT abnormality to be topographically aligned and included comMR (MRW + pRNFLT x (Average MRW Healthy eyes / Average pRNFLT Healthy eyes). RESULTS TC sectoral criteria (1 GH MRW + corresponding GH RNFLT), (1 30° MRW + any 1 corresponding or adjacent 30° pRNFLT), 30⁰ and GH comMR and global comMR were the best performing criteria, demonstrating: (96-99% specificity); 86-91% sensitivity for GL; 80-84% sensitivity for early GL (MD ≥ -4.0 dB) and 93-96% sensitivity for moderate-to-advanced GL (MD < -4.0 dB). CONCLUSIONS Clinically intuitive TC MRW and pRNFLT combination criteria identified the sectoral location of OCT abnormality in GL eyes with high diagnostic precision.