Discrimination between Glaucomatous and Nonglaucomatous Eyes Using Quantitative Imaging Devices and Subjective Optic Nerve Head Assessment

DeLeón-Ortega, Julio; Arthur, Stella N.; McGwin, Gerald; Xie, Aiyuan; Monheit, Blythe E.; Girkin, Christopher A.

doi:10.1167/iovs.05-1239

Cited by 163 publications

(138 citation statements)

References 25 publications

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“…In other words, a technician using HRT3 may achieve the diagnostic accuracy of an expert when dealing with these difficult cases. These results are consistent with those of other studies, [39][40][41][42] in which the HRT2 was reported to have a similar sensitivity for diagnosing glaucoma as clinical assessment using stereoscopic optic disc photographs, and provide validation for the HRT3. …”

Section: Discussionsupporting

confidence: 91%

Optic nerve head changes in early glaucoma: a comparison between stereophotography and Heidelberg retina tomography

Pablo

Ferreras

Fogagnolo

et al. 2009

Eye

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Objective To evaluate and compare the diagnostic accuracy of the Heidelberg retina tomograph (HRT) version 3 with that of glaucoma specialists using stereophotography in discriminating between normal eyes and patients with early glaucomatous visual field loss. Methods A total of 105 eyes of 105 individuals were prospectively and consecutively recruited. The sample comprised 51 normal and 54 early glaucomatous eyes, as defined by intraocular pressure and standard automated perimetry results, regardless of optic disc appearance. Receiver operating characteristic (ROC) curves were plotted for the HRT3 parameters and a linear discriminant function (LDF) developed in our hospital. Best sensitivity-specificity pairs were compared between the HRT3 parameters, with the highest areas under the ROC curve (AUCs) and evaluation of optic disc stereophotographs. Agreement between methods for measuring vertical cup-to-disc ratio was evaluated with the Bland-Altman plot. Results The average visual field mean deviation was -2.90 dB. The HRT3 parameters with the largest AUCs were our LDF (0.900), rim volume (0.883), and vertical cup/disk ratio (0.880), with no significant differences between these parameters. Sensitivity-specificity pairs were 79.6-100% (clinical evaluation), 83.3-86.3% (our LDF), 64.8-96.1% (final glaucoma probability score), and 68.5-90.2% (global Moorfields regression analysis). ConclusionsThe diagnostic accuracy for differentiating normal eyes from those with early visual field defects was similar between clinical evaluation of the optic disc and evaluation with the HRT3. The use of our LDF increased the sensitivity-specificity balance with respect to the HRT-provided parameters. The diagnostic accuracy of the HRT classifications was comparable to that of an experienced glaucoma specialist.

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Section: Discussionsupporting

confidence: 91%

Optic nerve head changes in early glaucoma: a comparison between stereophotography and Heidelberg retina tomography

Pablo

Ferreras

Fogagnolo

et al. 2009

Eye

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“…[1][2][3][4][5][6][7] The Moorfields Regression Analysis (MRA) was developed to improve the diagnostic accuracy of the HRT by taking into consideration that neuroretinal rim area is affected by disc area and age, and that the glaucomatous process frequently involves thinning of some sectors of the neuroretinal rim in greater extent than others. Thus, MRA utilizes estimates from global and 6 sectors of the neuroretinal rim area adjusted for optic disc size and age in an effort to improve specificity and it has shown to discriminate glaucomatous and non-glaucomatous eyes with high degree of sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Diagnostic Accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to Discriminate Glaucomatous and Nonglaucomatous Eyes

León-Ortega

Sakata

Monheit

et al. 2007

American Journal of Ophthalmology

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Purpose-To compare the diagnostic accuracy of the Moorfields Regression Analysis (MRA), parameters, and Glaucoma Probability Score (GPS) from Heidelberg Retinal Tomograph HRT-3 with MRA and parameters from HRT-II in discriminating glaucomatous and healthy eyes in subjects of African (AA) and European ancestry (EA). Design-case-control, institutional setting.Methods-78 glaucoma patients (AA=44, EA=34) and 89 age-matched controls (AA=46, EA=33), defined by visual fields and self-reported race were included. Imaging was obtained with HRT-II and data were exported to a computer with the HRT-3 software using the same contour line. Area under Receiver-operating Characteristic [ROC] curves [AUC], sensitivity and specificity were evaluated for whole group, AA and EA separately. Mean disc area was compared between correctly and incorrectly diagnosed eyes by each technique.Results-Disc, cup and rim areas from HRT3 were lower than HRT-II (P<0.0001). AUC (sensitivity at 95%-specificity) was 0.85 (54%) for vertical cup-to-disc ratio (VCDR) HRT3, 0.84 (45%) for VCDR and 0.81 (44%) for GPS score at temporal sector. MRA-HRT3 showed greater sensitivity but lower specificity than HRT-II for whole group, AA and EA. GPS classification had lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller

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“…O estudo de subpopulações de células ganglionares associados à espessura da camada de fibras nervosas da retina e topografia do disco óptico são maneiras diferentes de tentar diagnosticar e acompanhar o paciente glaucomatoso. A combinação de diferentes mé-todos pode proporcionar melhores índices diagnósticos, conforme Deleón-Ortega et al (27) e Medeiros et al (28) .…”

Section: Discussionunclassified

Análise de regressão logística na combinação de métodos propedêuticos no diagnóstico do glaucoma

Fasolo

Júnior

Barbosa

et al. 2013

Arq. Bras. Oftalmol.

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INTRODUÇÃOO diagnóstico de glaucoma, classicamente se tem baseado na observação do disco óptico com características glaucomatosas, associado a defeitos correspondentes de campo visual, geralmente com níveis estatisticamente alterados de pressão intraocular (1) . Contudo, nem sempre o diagnóstico é evidente, principalmente em suas fases precoces. Desta forma, outras modalidades propedêuticas têm sido investigadas com a finalidade de proporcionar uma detecção mais precoce do dano glaucomatoso (1)(2)(3)(4)(5) . O exame da camada de fibras nervosas da retina (CFN) com o uso da polarimetria de varredura a laser foi introduzido na propedêutica do glaucoma, com o objetivo de proporcionar o diagnóstico precoce da doença através da medida da espessura da CFN (6)(7)(8) . Vários autores salientam que os defeitos na CFN precedem, em até anos, os observados no campo visual (9,10) . A perimetria com estímulo azul em fundo amarelo é realizada nos mesmos princípios que a técnica convencional com fundo e estímulo brancos e baseia-se nos relatos que as células ganglionares Análise de regressão logística na combinação de métodos propedêuticos no diagnóstico do glaucoma RESUMO

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Discrimination between Glaucomatous and Nonglaucomatous Eyes Using Quantitative Imaging Devices and Subjective Optic Nerve Head Assessment

Cited by 163 publications

References 25 publications

Optic nerve head changes in early glaucoma: a comparison between stereophotography and Heidelberg retina tomography

Optic nerve head changes in early glaucoma: a comparison between stereophotography and Heidelberg retina tomography

Comparison of Diagnostic Accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to Discriminate Glaucomatous and Nonglaucomatous Eyes

Análise de regressão logística na combinação de métodos propedêuticos no diagnóstico do glaucoma

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