Comparison of Cirrus OCT and Stratus OCT on the Ability to Detect Localized Retinal Nerve Fiber Layer Defects in Preperimetric Glaucoma

PURPOSE. To evaluate and compare the diagnostic ability of Cirrus and Stratus optical coherence tomography (OCT) to detect localized retinal nerve fiber layer (RNFL) defects in patients with normal standard automated perimetry. METHODS. This study included 55 eyes of 55 subjects with preperimetric localized RNFL defects and 55 normal control eyes of 55 age-and sex-matched subjects. Areas under the receiver operating characteristic curves (AUROCs) were calculated and compared. Based on the internal normative database from each device, the sensitivity and specificity for detecting preperimetric localized RNFL defects were calculated. RESULTS. There was no statistically significant difference between the AUROCs for the best parameters from the Cirrus OCT (inferior thickness, AUROC = 0.728) and Stratus OCT (7 o'clock sector, AUROC = 0.760; P = 0.477). The sensitivity of the Cirrus OCT parameters ranged from 21.0% to 87.1% and that of the Stratus OCT parameters ranged from 4.8% to 30.7%, with the criterion of abnormal at the 5% level. Based on the normative database, the highest Cirrus OCT sensitivity was obtained with the deviation-from-normal map (sensitivity 87.1% and specificity 61.8%), and the highest Stratus OCT sensitivity was obtained with the TSNIT thickness graph (sensitivity 30.7% and specificity 85.5%). CONCLUSIONS. There were no significant differences between the AUROCs for Cirrus and Stratus OCT, indicating that the two devices have similar diagnostic potentials in preperimetric glaucoma. After comparison with their normative databases, Cirrus OCT had generally higher sensitivities; however, this was largely at the cost of lower specificities than Stratus OCT. (Invest Ophthalmol Vis Sci. 2010; 51: 938-945) DOI:10.1167/iovs.08-3335