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H. Uchida, H. Saito, A. Iwase, A. Tomidokoro, M. Araie, T. Yamamoto, M. Shirakashi, K. Yaoeda, Y. Ohno; Improvement of Glaucoma Diagnosis With Heidelberg Retina Tomography (HRT) in Japanese Myopic Eyes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3316.
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© ARVO (1962-2015); The Authors (2016-present)
Myopia, a risk factor for open angle glaucoma (OAG), is much more prevalent in Japanese than in Caucasians and ellipse-shaped optic discs are frequently seen in Japanese with myopia. We tried to improve glaucoma diagnostic power of HRT by incorporating a parameter representing ovality into discriminant function in glaucoma eyes associated with myopia.
Spherical equivalent refraction of all subject eyes was ≤ -3D and one eye from a subject was used HRT I data obtained in 69 OAG(48.4±10.8 yrs old, MD; -6.20±5.43) and 66 normal eyes (38.0±11.3 yrs old), and HRT II data obtained in 33 OAG(60.3±7.4 yrs old, MD; -5.32±5.73) and 18 normal eyes (49.2±6.8 yrs old) were included. The ratio of disc diameter along the long axis of the disc which was determined on the HRT print out to that along the short axis perpendicular to the long axis (L/S ratio) was used as a parameter of ovality of the disc. Using eyes with HRT I data, significantly contributing HRT parameters to discrimination between glaucoma and normal eyes were searched by step-wise method and the discriminant function thus obtained was applied to eyes with HRT II data. Sensitivity and specificity of the obtained discriminant function (JHC) was compared to those of the Moorfields regression classification (MRC), and the HRT classification (FMS).
A discriminant function y= 1.505*L/S ratio+0.039*age+1.362*rim area+6.532*height variation contour-8.676*rim volume+6.895*cup shape measure-4.063, was obtained. Sensitivity and specificity of the JHC, MRC and FMS were 93% and 83%, 73% and 83% and 75% and 88%, respectively in eyes with HRT II data. Sensitivity of the JHC was better than that by MRC or FMS (p<0.01), while specificity showed no significant difference (p>0.1) among the 3 methods.
Incorporating of a parameter representing ovality of the disc improved the sensitivity of detecting glaucoma by HRT in Japanese myopic eyes.
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