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Victor T C Koh, Yih-Chung Tham, Carol Yim-lui Cheung, Baskaran Mani, Tien Yin Wong, Tin Aung; Diagnostic accuracy for glaucoma detection in a population-based study: Comparison of stereometric parameters from High-Definition Optical Coherence Tomography and Heidelberg Retinal Tomograph-3. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1017.
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© ARVO (1962-2015); The Authors (2016-present)
We aim to compare the diagnostic accuracy of High-Definition Optical Coherence Tomography (HD-OCT) and Heidelberg Retina Tomography 3 (HRT-3) to detect glaucoma in an Asian population.
Adults aged 40 to 80 years were consecutively recruited from the population-based Singapore Chinese Eye Study (n=3,353, response rate 72.8%). All subjects underwent a standardized ophthalmic examination and visual field tests. After pupil dilation, optic nerve head (ONH) imaging were performed with HRT-3 (Heidelberg Engineering, Heidelberg Germany) and Cirrus HD-OCT (Cirrus, software version 6.0, Carl Zeiss Meditec Inc, Dublin, CA). In addition, the Cirrus HD-OCT macular cube 200x200 acquisition protocol was used to measure the ganglion cell-inner plexiform layer (GC-IPL) thickness.Glaucoma was defined according to International Society for Geographical and Epidemiological Ophthalmology criteria. Area under the receiver operating characteristic curve (AUROC) for HD-OCT and HRT-3 parameters were derived and compared.
In total, 86 (4.79%) eyes of 60 glaucoma and 1709 eyes of 1001 non-glaucoma study subjects with completed data were included for analysis. The mean (± SD) age was 61.5 (9.5) years, 54.1% was male, mean intraocular pressure was 14.7 (3.1) mmHg, mean axial length was 23.6 (1.2) mm and mean disc size area was 1.98 (0.38) mm2. The visual field mean deviation was -7.81 (6.88) dB for the glaucoma eyes.The three largest AUROC for HRT-3 parameters were vertical cup-disc ratio [VCDR] (0.85), rim-disc area ratio (0.84) and mean retinal nerve fiber layer [RNFL] thickness (0.77). The three largest AUROC for HD-OCT ONH scan were VCDR (0.95), inferior RNFL thickness (0.90) and superior RNFL thickness (0.86). Similarly, for HD-OCT macular scan, the best parameters were average GC-IPL thickness (0.78), inferior GC-IPL thickness (0.78) and minimum GC-IPL thickness (0.77). Comparing the best parameter for each imaging technique, HD-OCT ONH scan performed significantly better than HRT-3 and HD-OCT macula scan (P = 0.0034).
Both HD-OCT and HRT-3 showed good diagnostic performance in discriminating glaucoma in this Chinese population-based study. Although HD-OCT ONH scan showed the best performance, more studies are required to determine its role in glaucoma screening in an Asian population.
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