Diagnostic Performance of Prespecified OCT Rules for Glaucomatous Optic Neuropathy in Nonpathologic Myopia.
Optical coherence tomography TSNIT curve rule detects glaucoma in myopic eyes with high accuracy externally
Diagnostic Performance of Prespecified OCT Rules for Glaucomatous Optic Neuropathy in Nonpathologic Myopia.
IMPORTANCE: Diagnosing glaucoma in myopic eyes is challenging due to overlapping structural features, such as optic disc tilt and retinal nerve fiber layer (retinal nerve fiber layer) bundle shifts.
To evaluate the diagnostic performance of prespecified optical coherence tomography (optical coherence tomography) rules for detecting glaucomatous optic neuropathy in myopic eyes across diverse international populations and devices.
DESIGN, SETTING, AND PARTICIPANTS: This multicenter diagnostic study used a sequential 2-phase design consisting of a modified Delphi process to prespecify diagnostic rules and a cross-sectional diagnostic validation.
Of 1525 eligible eyes (mean [SD] participant age, 45.9 [17.2] years; 665 eyes [43.6%] from 402 female participants), 814 (53.4%) had confirmed glaucomatous optic neuropathy.
Rule A demonstrated the highest diagnostic utility.
In the internal cohort (n = 841), sensitivity was 0.96 (95% CI, 0.94-0.98) and specificity was 0.95 (95% CI, 0.92-0.97).
In this multicenter diagnostic study, morphological assessment of TSNIT curves and combinatorial analysis of inferior retinal nerve fiber layer and inferotemporal mGC-IPL thinning demonstrated high diagnostic accuracy for glaucomatous optic neuropathy in nonpathologic myopic eyes.
These expert-derived rules offer objective, generalizable decision support for reducing diagnostic uncertainty in the myopic population.