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Abstract #95860 Published in IGR 22-3
The Inferior, Superior, Temporal Rim Width Pattern (IST Rule) Detects Glaucoma in a Japanese Population
Iwase A; Sawaguchi S; Tanaka K; Tsutsumi T; Araie MJournal of Glaucoma 2022; 31: 228-234
PRECIS: The inferior>superior>temporal rim width rate (IST pattern) rather than inferior≥superior≥nasal≥temporal (ISNT) pattern was suited for screening glaucoma in Japanese. Failure of the IST pattern was associated with several important risk factors for glaucoma. PURPOSE: The purpose of this study was to find a rim width rate pattern to yield the highest positive likelihood ratio (LR+) in detecting glaucoma eyes and to identify risk factors for glaucoma correlating with its failure in a population-based setting. METHODS: Disc stereophotographs of 2474 eyes of 2474 normal subjects and 237 eyes of 237 glaucoma subjects found in the Kumejima Study were analyzed using computer-assisted planimetry. Among all combinations of the inferior (I), superior (S), nasal (N) and/or temporal (T) rim width rate, a pattern showing the highest LR+ was selected and risk factors for glaucoma correlating with its failure were determined using multiple logistic regression analysis. RESULTS: The average I, S, N, and T rim widths (SD) were 0.45 (0.10), 0.39 (0.09), 0.47 (0.11), and 0.27 (0.07) mm. Among all combinations, the I>S>T rim width rate pattern (IST pattern) disregarding the N rim width showed the highest LR+ of 2.002 (95% confidence interval, 1.778-2.253). Failure of the IST pattern in normal eyes correlated with a smaller disc area (P<0.001) and disc ovality (P=0.005) and larger β-peripapillary area (P<0.001) and compliance with in glaucoma eyes with a smaller β-PPA area (P=0.027), thicker central corneal thickness (P=0.017), lower intraocular pressure (P=0.019), and higher body mass index (P=0.037). CONCLUSION: Among all combinations, the I>S>T rim width pattern, the IST pattern, yielded the highest LR+ in detecting glaucoma eyes in Japanese and its failure of or compliance with the pattern significantly correlated with several known risk factors for glaucoma.
Tajimi Iwase Eye Clinic, Tajimi, Gifu Prefecture Department of Ophthalmology, University of the Ryukyus Graduate School of Medicine, Nishihara, Okinawa Prefecture Department of Ophthalmology, University of Tokyo Graduate School of Medicine Kanto Central Hospital of The Mutual Aid Association of Public School Teachers, Tokyo, Japan.
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