Delta Journal of Ophthalmology · Published 2026-04-01 · DOI 10.4103/djo.djo_42_25
Objective The aim of this study was to evaluate the accuracy of Spectralis optical coherence tomography (OCT) in detecting glaucomatous changes in the optic nerve head and retinal nerve fiber layer (RNFL) in patients with primary open-angle glaucoma (POAG). Patients and methods This prospective case–control study was conducted at the Department of Ophthalmology at Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. It included 76 participants: 38 patients with POAG and 38 healthy controls. Both eyes were evaluated using the Spectralis OCT to measure the optic disc area, rim area, cup-to-disc ratio (CDR), horizontal and vertical CDR (HCDR and VCDR), and horizontal and vertical rim thickness. Quadrant-wise RNFL assessment was also performed. The diagnostic performance of the OCT parameters was analyzed using the receiver operating characteristic curves, and the sensitivity and accuracy for glaucoma detection were calculated. Results The disc area showed no statistically significant difference between glaucomatous and normal eyes (P>0.05). In contrast, in the POAG group, the rim area was significantly reduced, while the CDR, HCDR, and VCDR were significantly higher compared to the controls (P<0.01). The horizontal and vertical rim thickness were significantly greater in the control group (P<0.01), reflecting structural thinning in the glaucomatous eyes. The RNFL abnormalities were most commonly detected in the nasal and inferotemporal quadrants. The receiver operating characteristic analysis demonstrated significant diagnostic capability for all OCT parameters, with the CDR showing the highest discriminative power (area under the curve=0.977) at a cut-off value more than 0.46. Conclusion Spectralis OCT provided a reliable and accurate assessment of optic nerve head and RNFL changes in POAG with the CDR being the best predictor.
Abstract from DOAJ. Public domain (CC0 1.0).
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