April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Improvement of Glaucoma Classification based on HRT using a Multi Parameter Analysis and the Relationship to Spectralis RNFL Thickness Measurements
Author Affiliations & Notes
  • Stephan Schulz
    Heidelberg Engineering Academy, Heidelberg Engineering, Heidelberg, Germany
  • Christian Y. Mardin
    Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany
  • Martin Diller
    Heidelberg Engineering Academy, Heidelberg Engineering, Heidelberg, Germany
  • Anselm G. Jünemann
    Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany
  • Ralf P. Tornow
    Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany
  • Folkert K. Horn
    Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany
  • Robert Laemmer
    Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany
  • Footnotes
    Commercial Relationships  Stephan Schulz, Heidelberg Engineering (E); Christian Y. Mardin, None; Martin Diller, Heidelberg Engineering (E); Anselm G. Jünemann, None; Ralf P. Tornow, Heidelberg Engineering (F); Folkert K. Horn, None; Robert Laemmer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 175. doi:
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      Stephan Schulz, Christian Y. Mardin, Martin Diller, Anselm G. Jünemann, Ralf P. Tornow, Folkert K. Horn, Robert Laemmer; Improvement of Glaucoma Classification based on HRT using a Multi Parameter Analysis and the Relationship to Spectralis RNFL Thickness Measurements. Invest. Ophthalmol. Vis. Sci. 2011;52(14):175.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Evaluation of the diagnostic benefit of a fast comprehensive multi parameter test on disc morphology and its relationship to RNFL thickness measurements in preperimetric and early perimetric glaucoma.

Methods: : 64 controls, 77 preperimetric primary open angle glaucoma (POAG) and 63 early perimetric POAG patients were recruited from the Erlangen Glaucoma Registry. Heidelberg Retina Tomograph (HRT 3) and Spectralis HRA+OCT (both Heidelberg Engineering, Germany) scans were obtained. Retinal nerve fibre layer (RNFL) measurements (circular B-scans: 3.4 mm diameter, 768 A-scans, 25 sweeps) were used as observer independent reference. HRT images were anonymized, masked and evaluated by three experienced investigators. HRT qualitative variables were reflectivity of retinal surface, configuration of double-hump pattern, shape of the cup and fulfilled ISNT-rule. The standard quantitative variables were rim-volume, cup shape measure, FSM, RB, Moorfields analysis (MRA) and glaucoma probability score (GPS). A new additive score for glaucoma was created ranging from 0 to 10. Area under ROC (AUROC) and specificities at a fixed sensitivity have been calculated (SPSS, Version 18.0; Chicago, IL, USA) to evaluate predictive value for glaucoma.

Results: : The overall HRT score and RNFL-thickness were significantly different from normals in both diagnostic groups. AUROC curves for preperimetric POAG were: averaged score 0.789, MRA 0.744, GPS 0.686 and for RNFL-thickness 0.916. For perimetric POAG: averaged score 0.920, MRA 0.853, GPS 0.826 and for RNFL-thickness 0.965. Sensitivities at fixed specificity of at least 90% were for preperimetric POAG: averaged score 41.7 %, MRA 32.9%, GPS 28.9 % and for RNFL-thickness 78.9%. For perimetric PAOG: averaged score 73.1 %, MRA 58.1%, GPS 48.4 % and for RNFL-thickness 93.5%. The cut off point for the averaged score was 3.

Conclusions: : To differentiate normal from glaucoma eyes RNFL-thickness with Spectralis was the variable with the highest sensitivity followed by the score. Multi parameter analysis improves glaucoma classification based on HRT.

Keywords: imaging/image analysis: clinical • optic disc • nerve fiber layer 
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