April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Diagnostic Innovations in Glaucoma Study (DIGS): Diagnostic Accuracy of the Spectralis Normative Database in Differentiating between Healthy and Early Visual Field Defect Eyes
Anna Silverman; Lucie Sharpsten; Felipe A Medeiros; Naira Khachatryan; Naama Hammel; Christopher A Girkin; Jeffrey M Liebmann; Robert N Weinreb; Linda M Zangwill
Author Affiliations & Notes
  • Anna Silverman
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Lucie Sharpsten
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Felipe A Medeiros
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Naira Khachatryan
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Naama Hammel
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Christopher A Girkin
    School of Medicine, University of Alabama, Birmingham, AL
  • Jeffrey M Liebmann
    Department of Ophthalmology, New York University School of Medicine, New York, NY
    Department of Ophthalmology, Einhorn Clinical Research Center, New York, NY
  • Robert N Weinreb
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Linda M Zangwill
    Hamilton Glaucoma Center Department of Ophthalmology, University of California San Diego, La Jolla, CA
  • Footnotes
    Commercial Relationships Anna Silverman, None; Lucie Sharpsten, None; Felipe Medeiros, Alcon Laboratories Inc (F), Alcon Laboratories Inc (R), Allergan Inc. (C), Allergan Inc. (F), Allergan Inc. (R), Bausch & Lomb (F), Carl Zeiss Meditec Inc. (C), Carl Zeiss Meditec Inc. (F), Carl Zeiss Meditec Inc. (R), Heidelberg Engineering Inc. (F), Merck Inc. (F), National Eye Institute (EY021818) (F), Novartis (C), Reichert Inc. (F), Reichert Inc. (R), Sensimed (F), Topcon Inc. (F); Naira Khachatryan, None; Naama Hammel, None; Christopher Girkin, Alcon Laboratories Inc (R), Allergan Inc. (R), Carl Zeiss Meditech Inc. (F), Eyesight Foundation of Alabama (P30EY022589) (F), Heidelberg Engneering (F), Merck Inc. (R), Pfizer Inc. (R), Santen Inc. (R), SOLX (F); Jeffrey Liebmann, Alcon Laboratories Inc. (C), Allergan Inc. (C), Allergan Inc. (F), Bausch & Lomb Inc. (C), Bausch & Lomb Inc. (F), Carl Zeiss Meditech Inc. (F), Diopysis Inc. (C), Diopysis Inc. (F), Edith C. Blum Research Fund of the New York Glaucoma Research (F), Heidelberg Engineering (C), Heidelberg Engineering (F), Merz Pharmaceuticals Inc. (C), Optovue Inc. (F), Quark Pharmaceuticals Inc. (F), Reichert Inc. (F), Research to Prevent Blindness (F), Sensimed Inc. (F), Topcon Inc. (F), Valeant Pharmaceuticals Inc. (C); Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Bausch & Lomb (C), Carl Zeiss Meditec Inc. (C), Carl Zeiss Meditec Inc. (F), Genentech (F), Heidelberg Engineering Inc. (F), National Eye Institute (F), Nidek (F), Novartis (F), Optovue (F), Sensimed Inc. (C), Topcon Inc. (C), Topcon Inc. (F); Linda Zangwill, Alcon Laboratories Inc. (R), Allergan (R), Carl-Zeiss Meditec Inc. (F), Heidelberg Engineering GmbH (F), National Eye Institute (U10EY14267) (F), National Institute of Health (EY019869) (F), National Instituted of Health (EY11008) (F), Nidek Inc. (F), Optovue Inc. (F), Pfizer Inc. (R), Research to Prevent Blindness (F), Santen Inc. (R), Topcon Medical Systems Inc. (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4773. doi:
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      Anna Silverman, Lucie Sharpsten, Felipe A Medeiros, Naira Khachatryan, Naama Hammel, Christopher A Girkin, Jeffrey M Liebmann, Robert N Weinreb, Linda M Zangwill; Diagnostic Innovations in Glaucoma Study (DIGS): Diagnostic Accuracy of the Spectralis Normative Database in Differentiating between Healthy and Early Visual Field Defect Eyes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4773.

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Abstract

Purpose: To evaluate the diagnostic accuracy of the global and sector analysis for detection of early visual field damage using the normative database of the Spectralis spectral-domain optical coherence tomography (SD-OCT).

Methods: Glaucoma suspects defined as having ocular hypertension (OHT; IOP > 21 mm Hg) or a suspicious appearing optic disc (GON) at baseline without a history of repeatable visual field damage from the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES) with at least 2 years of follow-up were included. Healthy eyes defined as having no history of repeatable visual field damage or ocular hypertension were included. Global and sectoral retinal nerve fiber layer thickness (RNFLT) was measured using the Spectralis SD-OCT classified as within normal limits (WNL), borderline (BL) and outside normal limits (ONL). The sensitivity of ONL classification was estimated at the time glaucoma suspect eyes developed repeatable visual field damage (VFD) and/or abnormal photos. The specificity of WNL classification was estimated in healthy eyes.

Results: 463 glaucoma suspect eyes and 338 healthy eyes were included. 27 of 236 eyes in the GON group and 18 of 227 eyes in the OHT group developed VFD. The average MD was -0.36, 0.08 and -0.03 for the GON, OHT and healthy groups respectively. The sensitivity of the ONL classification among eyes with VFD was 7 (38.9%) among the OHT eyes and 15 (55.6%) in GON eyes. Few of the OHT and GON eyes that did not develop VFD, had an ONL classification (23 (11.0%) and 49 (23.4%), respectively) at their last follow-up visit. The specificity of WNL classification in healthy eyes was 323 (95.6%).

Conclusions: The Spectralis normative database has a high specificity for identifying healthy eyes. In eyes with very early visual field or photo damage, ONL classification was present in approximately 22 (48.9%) of glaucoma suspects. Longer follow up is needed to determine whether eyes classified as ONL without VFD will develop VFD in the future.

Keywords: 550 imaging/image analysis: clinical  
© 2014, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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