TNOA Journal of Ophthalmic Science and Research (Jan 2024)

Reviving the role of optical coherence tomography and visual field analysis as investigative tools for diagnosis of primary open-angle glaucoma in rural tertiary care centre

  • Mohan Ram Kumar,
  • R Deborah Rinita,
  • Machireddy R Sekhar Reddy,
  • G S Srinivasan

DOI
https://doi.org/10.4103/tjosr.tjosr_68_23
Journal volume & issue
Vol. 62, no. 1
pp. 68 – 74

Abstract

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Background: Glaucoma is the second most common cause of blindness globally and is characterised by raised intraocular pressure, optic disc cupping, and visual field defects. However, advanced imaging modalities such as optical coherence tomography (OCT) can pick up early changes. Our study aims to examine the role of OCT for the early diagnosis of primary open-angle glaucoma (POAG), its correlation with standard automated perimetry, and the diagnostic efficiency of both in POAG patients at a rural tertiary care centre in the Chengelpet District. Materials and Methods: This was a prospective observational study comparing the quantitative measurement of RNFL using OCT with functional loss analysed using the Automated Perimetry Humphrey Visual Field Analyzer in patients with POAG visiting the tertiary health centre in the Chengelpet district in Tamil Nadu. The study was conducted in 92 eyes of 50 patients diagnosed with POAG for 15 months from March 2022 to May 2023. Results: Of the 92 eyes of 50 patients, 26 were male patients and 24 were female patients. In total, 21 eyes had no demonstrable visual field defect, 49 eyes had single hemifield defect and 22 eyes had both hemifield defect. The area under the receiver operator characteristic curve for OCT RNFL layer measurement in patients diagnosed with visually confirmed ONH changes was 1.00, which was highly significant (P value = 0.01) and correlated well with the type of visual field defect with Humphrey's automated perimetry, suggesting significant correlation between the two. OCT–RNFL measurements are better diagnostic tests than standard automated perimetry for the early detection of glaucoma. Conclusion: Both OCT RNFL and Humphrey's automated visual field analysis play a most crucial role as an investigative modality for early diagnosis of POAG; however, OCT has an added advantage of detecting early glaucoma changes even without visible field changes and hence useful for very early detection of POAG in a tertiary care centre.

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