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Abstract #46364 Published in IGR 13-3
Combining rim area to disc area asymmetry ratio and Moorfields regression analysis of confocal scanning laser ophthalmoscopy for glaucoma screening
Kamdeu Fansi AA; Boisjoly H; Chagnon M; Harasymowycz PJCanadian Journal of Ophthalmology 2011; 46: 261-266
OBJECTIVE: To determine the utility of combining rim area to disc area asymmetry ratio (RADAAR) and Moorfields regression analysis (MRA) to detect primary open-angle glaucoma (POAG) using confocal scanning laser ophthalmoscopy (CSLO) (Heidelberg retina tomograph 3 (HRT3)) in high-risk populations. DESIGN: Cross-sectional study. PARTICIPANTS: Subjects with high risk for developing POAG. METHODS: Subjects underwent HRT, frequency doubling technology perimetry (FDT), and complete ophthalmic examination. Based on an ophthalmologic examination and FDT results of the worse eye, subjects were classified into 4 categories: normal, possible glaucoma, probable glaucoma, and definite glaucoma. Main outcome measures included sensitivities (Se), specificities (Sp), positive and negative predictive values (PPV, NPV), and positive and negative likelihood ratios (PLR, NLR) of the MRA, RADAAR, and combined MRA- RADAAR tests. RESULTS: Of 375 subjects, 11 were classified as having definite glaucoma. Depending on the reference standard, range results for Se, Sp, PPV, NPV, PLR, and NLR were, respectively, 57.7% to 100%; 55.1% to 85.4%; 6.3% to 39%; 92.6% to 100%; 1.97 to 4.9; 0 to 0.49 for MRA; 11.5% to 27.3%; 98.1% to 98.8%; 30% to 60%; 87.4% to 97.8%; 9.29 to 14.1; and 0.74 to 0.89 for RADAAR; and 57.7% to 90.9%; 81.3% to 85.1%; 12.8% to 38.5%; 92.6% to 99.7%; 3.87 to 4.85; 0.11 to 0.50 for combination MRA-RADAAR. DISCUSSION: When using HRT in populations at high risk for glaucoma, RADAAR had a higher specificity than MRA in identifying glaucoma. When patients were classified as borderline on MRA, combining RADAAR values decreased the number of false-positives as well, and may be recommended when high specificity is required.
Department of Ophthalmology, Centre de Recherche de l'Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada.
Classification:
1.6 Prevention and screening (Part of: 1 General aspects)
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
