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Antonio Ferreras, MD, PhD; Luís E. Pablo, MD, PhD; Ana B. Pajarín, MD, PhD; José M. Larrosa, MD, PhD; Vicente Polo, MD, PhD; Francisco M. Honrubia, MD, PhD

Arch Ophthalmol. 2008;126(4):465-470.

Objective  To determine and validate the diagnostic ability of a linear discriminant function (LDF) based on the retinal nerve fiber layer thickness at each of the 12 clock-hour positions obtained using optical coherence tomography for discriminating between healthy eyes and eyes with early glaucomatous visual field loss.

Methods  We prospectively selected 62 consecutive healthy individuals and 73 patients with open-angle glaucoma to calculate the LDF. Another independent prospective sample of 280 healthy eyes and 302 glaucomatous eyes was used to evaluate the diagnostic accuracy of the LDF.

Results  The proposed function was LDF = 15.584 – (12-o’clock segment thickness x 0.032) – (7-o’clock segment thickness x 0.041) – (3-o’clock segment thickness [nasal side] x 0.121). The greatest area under the receiver operating characteristic curve was observed for our LDF in both populations: 0.962 and 0.922. Our LDF and the average thickness yielded sensitivities of 74.5% and 67.8%, respectively, at a fixed specificity of 95%.

Conclusions  The LDF increased the diagnostic ability of the isolated retinal nerve fiber layer thickness at the 12 clock-hour positions. Compared with optical coherence tomography–provided parameters, our LDF had the highest sensitivities at 85% and 95% fixed specificities to discriminate between healthy and early glaucomatous eyes.

Author Affiliations: Department of Ophthalmology, Miguel Servet University Hospital (Drs Ferreras, Pablo, Larrosa, Polo, and Honrubia); and Family Medicine, Euroresidencias Zaragoza (Dr Pajarín), Zaragoza, Spain.

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