Comparing Diagnostic Accuracy of MRW and RNFL in Detection of Glaucoma
Purpose: To compare diagnostic accuracy of Bruch’s membrane opening minimum rim width (BMO-MRW) and Retinal Nerve Fibre Layer (RNFL) in detection of glaucoma taking cup to disc ratio as gold standard.
Study Design: Descriptive observational.
Place and Duration of Study: Liaquat National Hospital, Karachi from September 2017 to February 2018.
Methods: Total 344 participants including healthy and glaucoma suspect (according to the cup disc ratio or high intra ocular pressure more than 21 mmHg) were included. They were evaluated to compare diagnostic accuracy of MRW and RNFL taking cup to disc ratio as gold standard. Spectral domain OCT was performed. Sensitivity, specificity, and diagnostic accuracy of MRW and RNFL were calculated keeping cup-disc finding as gold standard.
Results: Mean Cup to Disk Ratio was 0.54 ± 0.10. Total 97.4% cases were diagnosed to have Glaucoma by Cup to Disk Ratio, 84.3% cases were diagnosed with Glaucoma by RNFL and 94.8% cases by MRW. By RNFL, 288 patients were true positive and 7 patients were true negative. Sensitivity, Specificity, and accuracy were 86.0%, 77.8%, and 85.7% respectively. The results showed that by MRW, 324 patients were true positive, and 7 patients were true negative. Sensitivity, Specificity, and accuracy were 96.7%, 77.8%, and 96.2% respectively.
Conclusion: The sensitivity of RNFL for diagnosis of glaucoma is higher than MRW. While the specificity of both RNFL and MRW was similar.
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