HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Medeiros, F. A. Articles by Weinreb, R. N. Search for Related Content PubMed PubMed Citation Articles by Medeiros, F. A. Articles by Weinreb, R. N.

Influence of Disease Severity and Optic Disc Size on the Diagnostic Performance of Imaging Instruments in Glaucoma

From the Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, California.

PURPOSE. To evaluate the influence of disease severity and optic disc size on the diagnostic accuracy of three imaging technologies for structural assessment in glaucoma: confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography.

METHODS. One hundred five patients with glaucoma and 61 normal subjects were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS). All individuals underwent imaging with the GDx Variable Corneal and Lens Compensator (VCC; Carl Zeiss Meditec, Inc., Dublin, CA), the Heidelberg Retina Tomograph II (HRT II; Heidelberg Engineering, GmbH, Dossenheim, Germany), and the Stratus OCT (Stratus OCT; Carl-Zeiss Meditec, Inc.) within a 6-month period. Severity of disease was based on the AGIS (Advanced Glaucoma Intervention Study) visual field score. To evaluate the influence of severity of glaucoma and optic disc size on the diagnostic accuracy of the imaging instruments, the sensitivities of the tests were fitted as a function of the AGIS score and disc area, by using logistic marginal regression models.

RESULTS. The severity of visual field loss had a significant influence on the sensitivity of all imaging instruments. More severe disease was associated with increased sensitivity. This influence was similar among the three instruments. With regard to optic disc area, larger optic discs were associated with decreased sensitivity for the Stratus OCT parameter Average Thickness and the GDx VCC parameter Nerve Fiber Indicator, whereas small optic discs were associated with increased sensitivity. For the HRT II parameter Moorfields regression analysis classification, an inverse effect was observed.

CONCLUSION. The diagnostic performances of the GDx VCC, HRT II, and Stratus OCT were significantly influenced by the severity of the disease and optic disc size. These covariates should be taken into account when comparing the performances of these tests for glaucoma diagnosis.

This article has been cited by other articles:

				A. Ferreras, L. E. Pablo, A. B. Pajarin, J. M. Larrosa, V. Polo, and F. M. Honrubia Logistic Regression Analysis for Early Glaucoma Diagnosis Using Optical Coherence Tomography Arch Ophthalmol, April 1, 2008; 126(4): 465 - 470. [Abstract] [Full Text] [PDF]

				G. Savini, P. Barboni, M. Carbonelli, and M. Zanini The Effect of Scan Diameter on Retinal Nerve Fiber Layer Thickness Measurement Using Stratus Optic Coherence Tomography Arch Ophthalmol, July 1, 2007; 125(7): 901 - 905. [Abstract] [Full Text] [PDF]

				C. Bowd Optical coherence tomography for clinical detection and monitoring of glaucoma? Br. J. Ophthalmol., July 1, 2007; 91(7): 853 - 854. [Full Text] [PDF]

				D C Hood, N Harizman, F N Kanadani, T M Grippo, S Baharestani, V C Greenstein, J M Liebmann, and R Ritch Retinal nerve fibre thickness measured with optical coherence tomography accurately detects confirmed glaucomatous damage Br. J. Ophthalmol., July 1, 2007; 91(7): 905 - 907. [Abstract] [Full Text] [PDF]

				L. M. Zangwill, S. Jain, L. Racette, K. B. Ernstrom, C. Bowd, F. A. Medeiros, P. A. Sample, and R. N. Weinreb The Effect of Disc Size and Severity of Disease on the Diagnostic Accuracy of the Heidelberg Retina Tomograph Glaucoma Probability Score Invest. Ophthalmol. Vis. Sci., June 1, 2007; 48(6): 2653 - 2660. [Abstract] [Full Text] [PDF]

				M. Sehi, S. Ume, D. S. Greenfield, and Advanced Imaging in Glaucoma Study Group Scanning Laser Polarimetry with Enhanced Corneal Compensation and Optical Coherence Tomography in Normal and Glaucomatous Eyes Invest. Ophthalmol. Vis. Sci., May 1, 2007; 48(5): 2099 - 2104. [Abstract] [Full Text] [PDF]

				T.-W. Kim, U.-C. Park, K. H. Park, and D. M. Kim Ability of Stratus OCT to Identify Localized Retinal Nerve Fiber Layer Defects in Patients with Normal Standard Automated Perimetry Results Invest. Ophthalmol. Vis. Sci., April 1, 2007; 48(4): 1635 - 1641. [Abstract] [Full Text] [PDF]

				R. S. Harwerth, A. S. Vilupuru, N. V. Rangaswamy, and E. L. Smith III The Relationship between Nerve Fiber Layer and Perimetry Measurements Invest. Ophthalmol. Vis. Sci., February 1, 2007; 48(2): 763 - 773. [Abstract] [Full Text] [PDF]

				C. Bowd, F. A. Medeiros, R. N. Weinreb, and L. M. Zangwill The Effect of Atypical Birefringence Patterns on Glaucoma Detection Using Scanning Laser Polarimetry with Variable Corneal Compensation Invest. Ophthalmol. Vis. Sci., January 1, 2007; 48(1): 223 - 227. [Abstract] [Full Text] [PDF]

				M.-L. Huang, H.-Y. Chen, and J.-C. Lin Rule Extraction for Glaucoma Detection with Summary Data from StratusOCT Invest. Ophthalmol. Vis. Sci., January 1, 2007; 48(1): 244 - 250. [Abstract] [Full Text] [PDF]

				A. Coops, D. B. Henson, A. J. Kwartz, and P. H. Artes Automated Analysis of Heidelberg Retina Tomograph Optic Disc Images by Glaucoma Probability Score Invest. Ophthalmol. Vis. Sci., December 1, 2006; 47(12): 5348 - 5355. [Abstract] [Full Text] [PDF]