Indian Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 2009  |  Volume : 57  |  Issue : 5  |  Page : 365--370

Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor


Mustafa Civelekler, Ismail Halili, Fatih C Gundogan, Gungor Sobaci 
 Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey

Correspondence Address:
Gungor Sobaci
Gulhane Askeri Tip Akademisi, Goz Hastaliklari A.D, 06018 Etlik-Ankara
Turkey

Purpose: To investigate the value of temporal retinal nerve fiber layer (RNFL temporal ) thickness in the prediction of malingering. Materials and Methods: This prospective, cross-sectional study was conducted on 33 military conscripts with optic disc temporal pallor (ODTP) and 33 age-and sex-matched healthy controls. Initial visual acuity (VA i ) and visual acuity after simulation examination techniques (VA aset ) were assessed. The subjects whose VA aset were two or more lines higher than VA i were determined as malingerers. Thickness of the peripapillary RNFL was determined with OCT (Stratus OCT�, Carl Zeiss Meditec, Inc.). RNFL temporal thickness of the subjects were categorized into one of the 1+ to 4+ groups according to 50% confidence interval (CI), 25% CI and 5% CI values which were assessed in the control group. The VAs were converted to LogMAR-VAs for statistical comparisons. Results: A significant difference was found only in the temporal quadrant of RNFL thickness in subjects with ODTP ( P =0.002). Mean LogMAR-VA increased significantly after SETs ( P <0.001). Sensitivity, specificity, positive and negative predictive values of categorized RNFL temporal thickness in diagnosing malingering were 84.6%, 75.0%, 68.8%, 88.2%, respectively. ROC curve showed that RNFL temporal thickness of 67.5 �m is a significant cut-off point in determining malingering ( P =0.001, area under the curve:0.862). The correlations between LogMAR-VAs and RNFL temporal thicknesses were significant; the correlation coefficient for LogMAR-VA i was lower than the correlation for LogMAR-VA aset (r=-0.447, P =0.009 for LogMAR-VA i ; r=-0.676, P <0.001 for LogMAR-VA aset ). Conclusions: RNFL temporal thickness assessment may be a valuable tool in determining malingering in subjects with ODTP objectively.


How to cite this article:
Civelekler M, Halili I, Gundogan FC, Sobaci G. Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor.Indian J Ophthalmol 2009;57:365-370


How to cite this URL:
Civelekler M, Halili I, Gundogan FC, Sobaci G. Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor. Indian J Ophthalmol [serial online] 2009 [cited 2024 Mar 4 ];57:365-370
Available from: https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2009;volume=57;issue=5;spage=365;epage=370;aulast=Civelekler;type=0