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C. Mendez-Hernandez, J. Garcia-Feijoo, A. Fernandez-Vidal, M. Gonzalez de la Rosa, J. Martinez-de-la-Casa, F. Saenz-Frances, J. Garcia-Sanchez; Diagnostic Results of Pulsar, Fdt and Flicker Perimetries in Patients With Ocular Hypertension. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1631.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the diagnostic capacity of PULSAR, FDT and Flicker perimetric tests, measuring their diagnostic accuracy in ocular hypertension and identifying the most useful parametric indexes for each procedure.
One hundred fifty four eyes, 83 with ocular hypertension (OHT) (IOP ≥21 mmHg) and 71 from healthy control subjects, were studied. Eyes were examined with the program N-30 of FDT, T-30W of PULSAR and TOP-Flicker. All the patients had normal White-White perimetry (loss variance square root or sLV-TOP G1-WW < 2.45). Eye fundus was assessed by glaucoma experts, only including those OHT and control patients with normal optic discs. Receiver operating characteristics (ROC) curves and sensitivity for a pre-established specificity of 90% for PULSAR and Flicker mean defect (MD) and loss variance (LV) as well as FDT mean deviation (MD) and pattern standard deviation (PSD) were calculated. Concordance (Κ) between ROC curves of each perimetric index was assessed.Logistic Regression Model was adjusted to calculate the ROC curve and Sensitivity and Specificity for the combination of PULSAR, Flicker and FDT perimeter indexes.
Mean pachymetry of OHT was 563.18+/-43.19 µ. A total of 39.19% had thin corneas (≤555µ), 35.14% intermediate ones (555-590µ) and 25.67% thick corneas (>590µ). Mean IOP in OHT was 23.52+/- 2,08 mmHg. The best area under the ROC curve (AUC) corresponded to PULSAR MD: 0.613 (p=0.015). Sensitivity obtained for a pre-established 90% Specificity was 25.30%. AUC for the combination of all the perimetric indexes analyzed was 0.623 (p=0.015), Sensitivity: 35.5%, Specificity: 83.1%. The best Odds Ratio values obtained corresponded to PULSAR MD: 1.234 (1.00-1.53) p=0.022. OHT percentage with pathological perimetries (at least one perimetric index outside of normality) was 33.73% for the PULSAR perimetry, 22.89% for the FDT perimetry and 13.25% for the Flicker perimetry.
PULSAR perimetry discriminates better between OHT and controls than Flicker and FDT ones. PULSAR has better sensitivity values when high specificity is required of the diagnostic procedure.
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