Objectives: The aim of this research was to evaluate the diagnostic performance
of Spectralis optical coherence tomography (OCT) parameters for ocular hypertensive (OH)
and glaucoma suspect (GS) eyes in an Asian population from Taiwan. Methods: This retrospective
cross-sectional study included 258 OH (mean deviation [MD]: −1.10 ± 1.75 dB),
380 GS (MD: −1.24 ± 2.63 dB), and 742 normal (MD: −1.47 ± 3.29 dB) eyes. The diagnostic
performance of Spectralis OCT parameters, including optic nerve head (ONH) and macular
parameters, was compared among groups. The area under the receiver operating characteristic
curve (AUC) of each parameter signified its power to differentiate between normal
and OH or GS eyes. Results: In various scanning protocols, circumpapillary retinal nerve
fiber layer (NFL)-temporal (AUC = 0.538), macular NFL-outer temporal (AUC = 0.611),
and retinal average thickness (RAT)_1.8 (AUC = 0.578) were the best parameters in distinguishing
OH eyes from normal eyes. Moreover, minimum rim width (MRW)-mean global
(AUC = 0.737), macular NFL-outer temporal (AUC = 0.558), and RAT_2.8 (AUC = 0.543)
were the best parameters in distinguishing GS eyes from normal eyes. After adjusting
for age and refraction effects, we determined that the AUCs for OH and GS were 0.694
and 0.646, respectively. Conclusions: Our real-world data indicate that Spectralis OCT
parameters show some potential for early glaucoma detection and monitoring, but their
current diagnostic effectiveness remains limited. When managing OH eyes, caution is
required in evaluating macular retinal NFL thickness in addition to the ONH. Bruch’s
membrane opening–MRW is a potential objective indicator of ONH changes in GS eyes.
