Spectralis Optical Coherence Tomography for Evaluating Ocular Hypertensive and Glaucoma Suspect Eyes: Real-World Data from Taiwan

OBJECTIVES: To evaluate the diagnostic performance of Spectralis optical coherence tomography (OCT) parameters for ocular hypertensive (OH) and glaucoma suspect (GS) eyes in an Asian population from Taiwan. METHODS: This retrospective cross-sectional study included 258 OH (mean deviation [MD]: −1.10 ± 1.75 dB), 380 GS (MD: −1.24 ± 2.63 dB), and 742 normal (MD: −1.47 ± 3.29 dB) eyes. The diagnostic performance of Spectralis OCT parameters, including optic nerve head (ONH) and macular parameters, was compared among groups. The area under the receiver operating characteristic curve (AUC) of each parameter signified its power to differentiate between normal and OH or GS eyes. RESULTS: In various scanning protocols, circumpapillary retinal nerve fiber layer (NFL)-temporal (AUC = 0.538), macular NFL-outer temporal (AUC = 0.611), and retinal average thickness (RAT)_1.8 (AUC = 0.578) were the best parameters in distinguishing OH eyes from normal eyes. Moreover, minimum rim width (MRW)-mean global (AUC = 0.737), macular NFL-outer temporal (AUC = 0.558), and RAT_2.8 (AUC = 0.543) were the best parameters in distinguishing GS eyes from normal eyes. After adjusting for age and refraction effects, we determined that the AUCs for OH and GS were 0.694 and 0.646, respectively. CONCLUSIONS: Our real-world data indicate that Spectralis OCT has clinical utility in evaluating OH and GS eyes in glaucoma practice in an Asian population. When managing OH eyes, caution is required in evaluating macular retinal NFL thickness in addition to the ONH. Bruch’s membrane opening-MRW is a potential objective indicator of ONH changes in GS eyes.