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The new Bruch’s membrane opening – minimum rim width classification improves optical coherence tomography specificity in tilted discs

Authors Rebolleda G, Casado A, Oblanca N, Muñoz-Negrete FJ

Received 20 August 2016

Accepted for publication 3 October 2016

Published 5 December 2016 Volume 2016:10 Pages 2417—2425

DOI https://doi.org/10.2147/OPTH.S120237

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Gema Rebolleda, Alfonso Casado, Noelia Oblanca, Francisco J Muñoz-Negrete

Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain

Background and objective: To investigate and compare the false-positive (FP) diagnostic classification of the Bruch’s membrane opening – minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness in healthy eyes with tilted optic disc.
Materials and methods: Fifty healthy eyes of 30 participants with tilted optic disc underwent BMO-MRW and RNFL scanning using Spectralis and macular Cirrus optical coherence tomography (OCT) scans.
Results: The overall FP rate was significantly lower using BMO-MRW map compared with both RNFL map by Spectralis (8% vs 62%, respectively, P<0.001) and ganglion cell analysis (GCA) map by Cirrus (8% vs 50%, respectively, P<0.001). Specificity was significantly higher using BMO-MRW than RNFL in eyes with low (89.7% vs 41.4%, P<0.001) and moderate myopia (95.2% vs 33.3%, P<0.001).
Conclusion: OCT-derived BMO-MRW analysis provides significantly greater specificity than RNFL in tilted disc irrespectively of the refractive error, and it is more specific than GCA analysis in tilted disc with moderate myopia.

Keywords: tilted disc, optical coherence tomography, false-positive, Bruch membrane

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