Multivariate normative comparison, a novel method for improved use of the retinal nerve fiber layer thickness to detect early glaucoma

Purpose To assess whether compensating the RNFL thickness for multiple demographic and anatomical factors improves detection of glaucoma. Methods This case-control study enrolled 2699 healthy participants to construct test a multivariate compensation model, which was then applied in 387 controls glaucoma cases (early, n = 219; moderate, 97; and, advanced, 71). Participants underwent Cirrus spectral-domain OCT (Carl Zeiss Meditec) imaging optic disc macular cubes. Compensated generated based on ethnicity, age, refractive error, (ratio, orientation, area), fovea (distance angle), retinal vessel density. measurements their corresponding areas under receiver operating characteristic curves (AUCs) were obtained. Results After applying Asian-specific standard deviation (SD) reduced, where effect greatest Chinese (16.9%), followed by Malays (13.9%) Indians (12.1%). Multivariate normative comparison outperformed measured discrimination early (AUC 0.90 vs 0.85; p < 0.001), moderate 0.94 0.91; 0.001) advanced 0.98 0.96; 0.001). Conclusions The database showed better capability than thickness, suggests there may be utility accounting variance improve detection.