Purchase this article with an account.
R. Mora, N. Harizman, J.R. Zelefsky, E. Ilitchev, J. Wen, C. Tello, R. Ritch, J.M. Liebmann; Assessment of a Race–Specific Normative Database on the Ability of the HRT–III to Differentiate Glaucomatous From Normal Eyes . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3367.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess the effect of a race–specific, normative HRT–III database on glaucoma sensitivity and specificity.
One eye of eligible normal and glaucoma patients was enrolled. All subjects underwent a full eye examination, standard achromatic perimetry (SITA–SAP, 24–2) and confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomograph, HRT–II) within one month of enrollment. Racial groups were defined by self–report. Glaucoma was defined by the existence of reproducible SAP loss (PSD<5% and/or GHT outside normal limits) on two consecutive fields. Normal subjects had two normal visual fields (PSD>5% and GHT within 99% normal limits) and a normal clinical examination. HRT–II exams were exported to the HRT–III software. HRT–III software includes a large race specific normative database consisting of 733 white and 215 black eyes. Moorfields regression analysis (MRA) for the most abnormal sector was compared between the HRT–II (MRA2) and the HRT–III before (MRA3–B) and after before (MRA3–A) adjustment for race. Sectors outside the 99.9% confidence interval limits ("outside normal limits") were determined to be abnormal.
126 black (52 glaucoma, 74 normal) and 98 white (32 glaucoma, 66 normal) subjects were enrolled. Mean age was 51±13 years and 49±16 years for blacks and whites respectively (p=0.26). Visual field mean deviation was –7.3 ± 6.7 db for glaucomatous eyes and –0.4 ± 1.1 for normal eyes (p<.001). Sensitivities and specificities for MRA–2, MRA–3B, and MRA–3A are listed in the table below. More eyes were classified as borderline using HRT–III software than HRT–II software.
A new, larger, race–specific HRT–III database increases sensitivity while maintaining specificity for white persons and increases sensitivity but decreases specificity for black persons. New software and databases based upon race require careful scrutiny prior to use in clinical practice.
This PDF is available to Subscribers Only