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Purpose <p>To assess and compare the diagnostic performance of Bruch’s membrane opening–minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness parameters in patients with early-stage glaucoma.</p> Material and method <p>This observational cross-sectional study included 60 eyes with primary open-angle glaucoma, 44 eyes with ocular hypertension (OHT), and 41 healthy control eyes. One eye per participant was randomly selected. All subjects underwent comprehensive ophthalmologic evaluation, including Goldmann applanation tonometry, gonioscopy, standard automated perimetry, spectral-domain optical coherence tomography, and dilated fundus examination. Global and sectoral RNFL thickness measurements, including standard and Anatomical Positioning System-based RNFL (APS-RNFL), as well as BMO-MRW parameters, were obtained using the Glaucoma Module Premium Edition (GMPE). Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUROC) globally and across six Garway–Heath sectors.</p> Results <p>For discrimination between glaucoma and healthy controls, global BMO-MRW demonstrated satisfactory diagnostic performance comparable to APS-RNFL, with AUROC values of 0.783 (95% CI: 0.690–0.859) and 0.827 (95% CI: 0.739–0.895), respectively. The highest AUROC for APS-RNFL was observed in the inferotemporal sector (0.810), while BMO-MRW showed its highest performance in the superotemporal sector (0.800), with no significant difference between the two parameters. BMO-MRW exhibited consistently good diagnostic accuracy across all sectors, whereas APS-RNFL demonstrated reduced performance in the superonasal, nasal, and inferonasal sectors (AUROC &lt;0.7). In differentiating OHT from healthy controls, global BMO-MRW outperformed APS-RNFL (AUROC: 0.625 vs. 0.504).</p> Conclusions <p>BMO-MRW is a reliable and effective parameter for the early diagnosis of glaucoma, showing consistent global and sectoral diagnostic performance compared with APS-RNFL.</p>

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Evaluation of Bruch’s membrane opening minimum rim width and retinal nerve fiber layer in patients with glaucoma and comparison with normal population

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Mustafa Davas,
  • Halit Oguz

摘要

Purpose

To assess and compare the diagnostic performance of Bruch’s membrane opening–minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness parameters in patients with early-stage glaucoma.

Material and method

This observational cross-sectional study included 60 eyes with primary open-angle glaucoma, 44 eyes with ocular hypertension (OHT), and 41 healthy control eyes. One eye per participant was randomly selected. All subjects underwent comprehensive ophthalmologic evaluation, including Goldmann applanation tonometry, gonioscopy, standard automated perimetry, spectral-domain optical coherence tomography, and dilated fundus examination. Global and sectoral RNFL thickness measurements, including standard and Anatomical Positioning System-based RNFL (APS-RNFL), as well as BMO-MRW parameters, were obtained using the Glaucoma Module Premium Edition (GMPE). Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUROC) globally and across six Garway–Heath sectors.

Results

For discrimination between glaucoma and healthy controls, global BMO-MRW demonstrated satisfactory diagnostic performance comparable to APS-RNFL, with AUROC values of 0.783 (95% CI: 0.690–0.859) and 0.827 (95% CI: 0.739–0.895), respectively. The highest AUROC for APS-RNFL was observed in the inferotemporal sector (0.810), while BMO-MRW showed its highest performance in the superotemporal sector (0.800), with no significant difference between the two parameters. BMO-MRW exhibited consistently good diagnostic accuracy across all sectors, whereas APS-RNFL demonstrated reduced performance in the superonasal, nasal, and inferonasal sectors (AUROC <0.7). In differentiating OHT from healthy controls, global BMO-MRW outperformed APS-RNFL (AUROC: 0.625 vs. 0.504).

Conclusions

BMO-MRW is a reliable and effective parameter for the early diagnosis of glaucoma, showing consistent global and sectoral diagnostic performance compared with APS-RNFL.