AvgLCT measurements made with the simplified version of the software.

<p>(A) Bar graph indicating LC thickness in patients with different stages of glaucoma (normal: n = 22, PPG: n = 28, OAG: n = 100). Note: there were significant differences between these groups (Kruskal-Wallis test followed by Steel-Dwass test). *: <i>P</i> < 0.01. (B) ROC curve. The area under the ROC curve was 0.91, with a cutoff value of 246.3 μm.</p

Clinical characteristics of patients with non-GE and GE discs.

<p>Clinical characteristics of patients with non-GE and GE discs.</p

Association between glaucoma parameters and average thickness of the LC (AvgLCT).

<p>(A) MD (B) cpRNFLT (C) vertical C/D ratio (D) tissue MBR.</p

Multiple regression analysis of independent variables affecting lamina cribrosa thickness.

<p>Multiple regression analysis of independent variables affecting lamina cribrosa thickness.</p

Simplified software technique for measuring lamina cribrosa (LC) thickness in a 4 x 4 grid.

<p>(A) 4 x 4 grid superimposed on an en-face image of the LC, showing the position of the B-scan images below. (B-E) Horizontal cross-sectional B-scan images, with orange dots indicating the anterior and posterior borders of the LC. Average LC thickness was defined as the average thickness in the 16 grid cells.</p

Evaluation of retinal nerve fiber layer defect using wide-field en-face swept-source OCT images by applying the inner limiting membrane flattening

<div><p>Purpose</p><p>The assessment of retinal nerve fiber layer defects (RNFLDs) is a useful part of glaucoma care. Here, we obtained en-face images of retinal layers below the inner limiting membrane (ILM) with swept source-optical coherence tomography (SS-OCT), and measured RNFLD angle with new software.</p><p>Methods</p><p>This study included 105 eyes of 105 normal tension glaucoma (NTG) patients (age, 59.8 ± 13.2). Exclusion criteria were best-corrected visual acuity < 0.5, axial length > 28 mm, non-glaucoma ocular disease, and systemic disease affecting the visual field. We obtained 12 x 9 mm 3D volume scans centered on the macula with SS-OCT (DRI OCT-1, Topcon), and from these scans, created 3 averaged en-face images, each comprising 7 horizontal en-face images (total thickness: 18.2 μm). We labeled these averaged images, according to their depth below the ILM, as en-face images 1 (shallowest), 2 (middle) and 3 (deepest). In each image, a circle was drawn centered on the disc, with a radius of half the distance between the centers of the disc and macula. The investigator marked points where the edge of the RNFLD intersected this circle, and RNFLD angle (RNFLDA) was calculated with new software. Finally, we analyzed the association between RNFLDA, cpRNFLT, weighted RGC count (wrgc) and Humphrey field analyzer (HFA)-measured mean deviation (MD) and hemifield total deviation (TD), both overall and in each hemifield.</p><p>Results</p><p>En-face image 2 had the highest interclass reproducibility for measuring RNFLDA (intra-rater intraclass correlation coefficient (ICC): 0.988, inter-rater ICC: 0.962). The correlation coefficients with RNFLDA were: HFA MD, -0.60; superior TD, -0.73; inferior TD, -0.69; overall cpRNFLT, -0.27; superior hemifield cpRNFLT, -0.39; and inferior hemifield cpRNFLT, -0.53 (all p<0.001).</p><p>Conclusions</p><p>RNFLDA measured in SS-OCT images had high reproducibility and was correlated to glaucoma severity. Our new method may be a valuable future part of glaucoma care.</p></div

Distribution of the correlation between local and overall lamina cribrosa (LC) thickness in a grid superimposed on the LC.

<p>(A) The numbers in the grid cells represent Spearman’s rank correlation coefficient. The cells highlighted in gray had a higher correlation coefficient. (B) The numbers in the grid cells represent the <i>P</i> value. The cells highlighted in gray were significantly correlated (<i>P</i> value < 0.05). (C) Map showing the position of 4 areas of high correlation, comprising 4, 12, 16, and 36 grid cells, respectively.</p

B-scan and en-face images.

<p>(A) B-scan image. The dotted lines (B-G) indicate the position of the en-face images below. (B) Upper area of the lamina cribrosa (LC). (C) Upper border of the LC. (D, E) Centerline of the LC. (F) Lower border of the LC. (G) Lower area of the LC.</p

Difference in the association between average lamina cribrosa thickness (avgLCT) and HFA MD in glaucoma patients with generalized enlargement (GE)-type discs and non-GE discs.

<p>(A) Representative appearance of a GE disc. (B) Comparison of avgLCT in patients with non-GE and GE discs.</p

Representative B-scan images of normal eyes, preperimetric glaucoma eyes, and eyes with normal-tension glaucoma.

<p>(A-C) B-scan images. (D-F) <i>en-face</i> images. (G-I) Grayscale Humphrey field analyzer image. (J-L) 12 clock-wise sectors of OCT-measured circumpapillary retinal nerve fiber layer thickness. (M-O) Representative lamina cribrosa (LC) thickness map showing the reliably measurable area. (A, D, G, J, M) Normal. (B, E, H, K, N) PPG. (C, F, I, L, O) Normal-tension glaucoma. Note: LC thickness gradually declined with glaucoma severity.</p