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Jagannath Nayak, Christopher Bowd, Felipe A Medeiros, Robert N Weinreb, Jeffrey M Liebmann, Christopher A Girkin, Linda M Zangwill; Heidelberg Retina Topograph Topographic Change Analysis in Progressing and Stable Eyes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):983.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the performance, in an independent population, of previously published confocal scanning laser ophthalmoscopy Topographic Change Analysis (TCA) parameter cut-offs for discriminating between progressing glaucoma and stable eyes.
Five published TCA cut-offs (Bowd et al., IOVS, 2009; Chauhan et al., IOVS, 2009) were applied to the following 4 groups: 54 eyes progressing by optic disc stereophotograph assessment (average follow-up time = 7.93, SD = 1.29 years), 81 eyes progressing by standard automated perimetry guided progression analysis (GPA) (5.20, SD = 2.55 years), 72 stable glaucoma eyes (patients tested 5 times over 5 weeks), and 135 healthy eyes (5.05, SD = 2.03 years). All eyes were imaged at least four times by HRT (Heidelberg Engineering, Inc.) as part of the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES). Sensitivity and specificity for classifying progressed and stable eyes were reported.
The two TCA parameters providing the best sensitivity/specificity trade-off were the 95% cut-off for the largest clustered super-pixel area within the optic disc margin (Bowd et al.) and the Moderate Criteria (largest clustered superpixel area within the optic disc margin ≥1% of the disc area with ≥50 µm mean depth change) (Chauhan et al.) (see Table). These cut-offs detected progression over a similar time frame. Specificity in healthy eyes was lower than in stable glaucoma eyes.
The performance of published TCA parameter cut-offs varies, as expected. Low specificity of TCA in healthy eyes might be due to the effects of aging on optic disc topography, evidenced by the long follow-up in this group. Confirmation of TCA changes in another group of healthy eyes is needed to determine whether this is the case.
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