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Editors Selection IGR 17-3
Progression: Performance of event and trend analysis for determining RNFL loss
Comment by Jost Jonas on:
48628 Computer simulation of progressive retinal nerve fiber layer loss in glaucoma: performance of event and trend analyses, Yu M; Weinreb RN; Yiu C et al., Investigative Ophthalmology and Visual Science, 2011; 52: 9674-9683
In their investigation on computer simulation of progressive retinal nerve fiber layer loss in glaucoma, Yu and colleagues compared the performance of trend analysis and event analysis for the detection of glaucoma progression. They found that trend analysis generally attained a sensitivity of ≥ 80% earlier-than-event analysis, although trend analysis had a lower sensitivity than event analysis for eyes with a large test-retest variability in the early follow-up period, albeit at a lower specificity. Independent of the test-retest variability and the pattern and rate of progression, trend analysis had an accuracy ≥ 80% earlier-than-event analysis. The authors concluded that although test-retest variability was an important determinant in glaucoma progression analysis, trend analysis generally outperformed event analysis for the detection of progression of retinal nerve fiber loss in glaucoma. This is a clinically important study, since the early detection of glaucoma progression has become the main focus in improving glaucoma diagnosis, and since the new imaging techniques have opened new avenues for measuring optic nerve structures. The results of the study have to be confirmed in clinical practice, and algorithms may be developed for the current imaging devices to then automatically detect progressive loss of retinal nerve fibers in glaucoma.
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