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Editors Selection IGR 10-4

Examination methods: Laser scanning: ONH topographic map analysis

Esther Hoffmann

Comment by Esther Hoffmann on:

18001 Detection of glaucomatous optic nerve head by using Heidelberg topographic maps, Iester M; Zanini M; Vittone P et al., Eye, 2007; 21: 609-613


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The study by Iester et al.(578) evaluates the diagnostic capability of an optic nerve head topographic map analysis using the confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph, HRT). By applying a new statistical method ('Euritics Analysis') to analyze the optic nerve head (ONH) in glaucoma eyes compared to normal eyes this analysis avoids drawing the contour line on the outer edge of the neuroretinal rim. The method has been introduced by Iester and coworkers in 1999. Using a small sample size of 20 randomly chosen eyes with glaucoma and 20 normal eyes they calculated sensitivity, specificity, and diagnostic precision of the ONH topographic map analysis. Their results are comparable to the published evidence, showing a sensitivity of 80%, a specificity of 75%, and a diagnostic precision of 77.5%. The advantage of the method by Iester and colleagues is the use of all points within the 10 image and the independence from having to draw a contour line. Similar to Swindale, the authors tried to develop a technique that is observer independent. It will be interesting to see how this technique compares to traditional techniques when tested in the same population.



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