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Editors Selection IGR 21-4

Examination methods: HRT II and GDx for screening

Comment by Esther Hoffmann on:

19470 A comparison of HRT II and GDx imaging for glaucoma detection in a primary care eye clinic setting, Andreou PA; Wickremasinghe SS; Asaria RH et al., Eye, 2007; 21: 1050-1055

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Andreou et al. (827) evaluate the performance of the HRT II and GDx nerve fiber analyzer (fixed corneal compensation) when used in a primary care eye clinic setting for glaucoma screening. One hundred and twelve subjects were included. Glaucoma diagnosis was based on the subjective assessment of a clinician masked to the results on GDx nerve fiber analyzer and the HRT. Glaucoma diagnosis was assessed by clinical examination of the optic disc as well as by perimetry. The clinician's diagnosis served as gold standard. Five groups were specified: Definite glaucoma, glaucoma suspect, Ocular hypertension, non glaucomatous optic neuropathy, and normal.

Imaging is an important additional tool in the diagnosis and the management of glaucoma

Both eyes were used for statistical analysis but presented separately. Sensitivity of the HRT II was 0.79 (Specificity 0.70) compared to 0.80 (specificity of 0.72) using the GDx. Agreement between the clinical diagnosis and HRT was 67%, and the GDx 69%, respectively. These results are in accordance with the reported results in other studies. Although a small sample size was used in this study, and the gold standard was the clinical diagnosis, this study shows again the importance of imaging methods as an additional tool in the diagnosis and the management of glaucoma.

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