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Arthi Balu, Mauro T. Leite, Linda M. Zangwill, Robert N. Weinreb, Pamela A. Sample, Felipe A. Medeiros; Agreement And Diagnostic Accuracy Of Spectral-domain Optical Coherence Tomography And Confocal Scanning Laser Ophthalmoscopy For Optic Nerve Head Topographical Evaluation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):200.
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To evaluate the agreement and compare the diagnostic abilities of spectral-domain optical coherence tomography and confocal scanning laser ophthalmoscopy for the evaluation of optic nerve head (ONH) parameters.
Two hundred and twenty eyes from 140 patients (57 healthy, 83 glaucoma) recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Study (ADAGES) were included in this observational cross-sectional study. All participants underwent imaging of the ONH using the Cirrus SDOCT (Carl Zeiss Meditec Inc.) and the Heidelberg Retina Tomograph (HRT; Heidelberg Engineering). Parameters obtained by the instruments and evaluated in this study were disc area, rim area, cup volume and vertical cup-to-disc ratio (VCDR). Agreement between the instruments was evaluated using Bland and Altman plots. Concordance correlation coefficients (CCC) were calculated to evaluate correlations between measurements obtained by each instrument. Age-adjusted areas under receiver operating characteristic curves (AUC) were calculated and compared.
Measurements obtained with the HRT were, on average, larger for disc area (1.97mm2 vs 1.90mm2; P<0.001) and rim area (1.31mm2 vs 1.10mm2; P<0.001) and significantly smaller for VCDR (0.45 vs 0.58; P<0.001) and cup volume (0.18mm3 vs 0.27mm3; P<0.001) than Cirrus. The CCC ranged from 0.48 for rim area (P<0.001) to 0.79 for disc area (P<0.001). The AUCs for the rim area were significantly larger for the Cirrus compared to the HRT (0.83 vs 0.71; P=0.003). No differences in diagnostic accuracy were found between Cirrus and HRT for the VCDR (AUC: 0.85 vs 0.82; P=0.28) and cup volume parameters (AUC: 0.78 vs 0.77; P=0.52).
Optic disc measurements obtained with the instruments were not entirely compatible and should not be used interchangeably. For rim area, but not cup-to-disc ratio or cup volume, the Cirrus showed a better performance than the HRT.
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