April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Heidelberg Retina Tomograph in Glaucoma Case-finding
Author Affiliations & Notes
  • Yves Wimmersberger
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
    Ophthalmology department, Vista Klinik, Binningen bei Basel, Switzerland
  • Ciara Bergin
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Justyna D. Oleszczuk
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Delphine Rivier
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Walter Ferrini
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Farid Achache
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Eamon Sharkawi
    Ophthalmology department, Hopital ophtalmique Jules Gonin, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships  Yves Wimmersberger, None; Ciara Bergin, None; Justyna D. Oleszczuk, None; Delphine Rivier, None; Walter Ferrini, None; Farid Achache, None; Eamon Sharkawi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 249. doi:https://doi.org/
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      Yves Wimmersberger, Ciara Bergin, Justyna D. Oleszczuk, Delphine Rivier, Walter Ferrini, Farid Achache, Eamon Sharkawi; Heidelberg Retina Tomograph in Glaucoma Case-finding. Invest. Ophthalmol. Vis. Sci. 2011;52(14):249. doi: https://doi.org/.

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

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Abstract

Purpose: : To compare the disease classification using optic nerve head imaging against clinical examination combined with perimetry in the case-finding environment.

Methods: : During a glaucoma screening event at the University Hospital in Lausanne 148 attendees opted to undergo an extended screening exam consisting of perimetry with Octopus (Haag-Streit, Koeniz, Switzerland), tonometry, gonioscopy, slit-lamp optic nerve head examination and Heidelberg Retinal Tomorgraph (HRT, Heidelberg engineering). Classification criteria of an abnormal clinical exam consisted of a cup to disc ratio > 0.6, other disc abnormality (e.g. notching), closed angles, Van Herrick < ¼ and intraocular pressure >21mmHg. In perimetry a square root loss variance (sLV) >3.0 dB was considered abnormal. Those cases with both an abnormal clinical exam and abnormal perimetric results were considered to be glaucoma suspects. An abnormal HRT exam was a global Moorfields Regression Analysis (MRA) result of "outside normal limits". The results from the worse eye for each instrument are reported.

Results: : The mean age of the patients was 59.9 years (SD ±14.8years). 46 subjects failed the clinical exam. 55 subjects had sLV>3.0dB. 86 subjects failed one or more of the testing components, 21 subjects failed both the clinical exam and perimetry. Two cases of advanced glaucoma were diagnosed on the day of the event. 20 subjects were referred due to other ocular pathology (10 cataract; 2 AMD; 8 other). 16 subjects were outside normal limits with the HRT, of which 11 failed the clinical exam, 9 failed the perimetric exam and 7 failed all three. HRT had a sensitivity of 33% CI [15%,57%] with a specificity of 93% CI [87%,97%].

Conclusions: : HRT shows good specificity, however the low sensitivity makes it of limited use in the proposed case finding scenario.

Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • perimetry 
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