Comparison of Glaucoma Diagnostic Capabilities of Cirrus HD and Stratus Optical Coherence Tomography

OBJECTIVE: To compare the glaucoma diagnostic capabilities offered by Stratus and Cirrus spectral-domain optical coherence tomography (OCT). METHODS: One hundred subjects with glaucoma and 74 healthy subjects were tested by Stratus and Cirrus OCT. Areas under the receiver operating characteristic curves (AUCs) of average, 4-quadrant, and 12-sector retinal nerve fiber layer thicknesses and sensitivities at fixed specificities (80% and 90%) were compared when the 2 OCT modalities were used to evaluate patients with early or moderate to advanced glaucoma. Likelihood ratios using normative classifications were reported. RESULTS: Overall, both OCT instruments showed similar glaucoma discrimination capability in average retinal nerve fiber layer thickness (AUC, 0.953 [Cirrus] vs 0.934 [Stratus]; P = .15). Cirrus OCT displayed significantly higher AUCs in the average, inferior, temporal, and superior quadrants and 7-o'clock measurements in early stages of glaucoma. The between-OCT instrument AUCs did not differ significantly in moderate to advanced stages. Abnormal results for both OCT instruments, after comparison with their normative databases, were associated with high likelihood ratios. CONCLUSIONS: In our series, the Cirrus OCT showed better glaucoma discrimination capability than Stratus OCT in early stages of glaucoma. Our findings suggest that spectral-domain technology of OCT may offer an improved capability of early-stage glaucoma detection.