Accuracy of the RTVue-100 Fourier-domain optical coherence tomograph in an optic neuropathy screening trial.

The aim of this study was to evaluate the usefulness of the RTVue-100 Fourier-domain optical coherence tomograph (RTVue-100 OCT) in screening for glaucoma and non-arteritic anterior ischemic optic neuropathy (NA-AION). In a non-population-based pre-publicised trial, self-recruited Caucasian participants were screened for glaucoma and NA-AION using the RTVue-100 OCT, and also by independent clinical examination. For the RTVue-100 OCT measurements, the optic nerve head (ONH) scan and the macular ganglion cell complex (GCC) scan were applied. Subjects with possible optic neuropathy (as indicated by any of the scans and/or by the clinical examination) underwent a detailed clinical investigation to verify or exclude the disease. Of the 146 attendees, 133 participants (256 eyes) successfully underwent the RTVue-100 OCT measurements. Of these, six eyes (2.3%) had glaucoma and three eyes (1.2%) had partial optic atrophy due to earlier NA-AION. The retinal nerve fibre layer (RNFL) parameters (provided by the instrument software) had 99.2-99.6% specificity, 96.5-96.9% accuracy, and positive likelihood ratio (PLR) of 27.3-54.7, but only 11.1-22.2% sensitivity. Accuracy and PLR for the ONH parameters were <95% and <8.3, respectively. The GCC scan of the macula provided up to 95.9% specificity, 94.0% accuracy, 10.7 PLR and 44.4% sensitivity. During the screening of this Caucasian population with 3.5% prevalence of optic neuropathy due to glaucoma and NA-AION, the RTVue-100 OCT was found to be useful for screening, with both RNFL and GCC parameters providing high accuracy and PLR values >10.