Bruch membrane opening-minimum rim width (BMO-MRW) assessment offers a new diagnostic use in glaucoma patients of the Glaucoma Module Premium Edition (GMPE) available for the Spectralis optical coherence tomography (OCT) system. The objective of our research was to evaluate the diagnostic benefits of examining BMO-MRW and peripapillary retinal nerve fibre layer (pRNFL) readings acquired with Spectralis OCT to distinguish between healthy and early-onset glaucoma patients, comparing those

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... with the standard pRNFL application. Moreover, we investigated whether using a particular combination of BMO-MRW and pRNFL parameters with a linear discriminant function (LDF) could further enhance glaucoma diagnosis. Methods: 136 eyes from 136 individuals were incorporated into this observational, prospective crosssectional study: 68 healthy control subjects and 68 early-onset primary open-angle glaucoma (POAG) patients. MRW and pRNFL thickness around the disc (diameters: 3.5 mm, 4.1 mm, and 4.7 mm) were obtained using the BMO-MRW protocol, and pRNFL thickness at 3.5 mm was obtained with the standard glaucoma application. The group data were contrasted. One sample was chosen at random to develop the LDF (teaching set: 34 healthy subjects and 34 POAG patients) using a combination of MRW and pRNFL parameters (acquired with the BMO-MRW protocol); the other sample provided a test of how the LDF performed on an independent group (validating set: 34 healthy subjects and 34 POAG patients). The receiver operating curves (ROCs) were plotted for every measurement and contrasted with the proposed LDF. The OCT parameters with the best area under the receiver operating characteristic curve (AUC) were determined. Results: Global MRW and pRNFL thicknesses were significantly thinner in the POAG group (p < 0.001). The BMO-MRW parameters showed good diagnostic accuracy; the largest AUCs reached 0.875 for the LDF and 0.879 for global RNFL thickness using the standard glaucoma application. There were no statistical differences between the AUCs calculated. Conclusions: BMO-MRW parameters show a strong capability to differentiate between early-onset glaucoma and control eyes. Our LDF based on the new BMO-MRW OCT protocol did not perform better than isolated parameters.