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L. M. Hoesl, R. P. Tornow, W. A. Schrems, F. K. Horn, C. Y. Mardin, F. E. Kruse, R. Laemmer; Influence of Typical Scan Score on Diagnostic Performance of Scanning Laser Polarimetry and Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):241.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the impact of typical scan score (TSS) on discriminating glaucoma patients and healthy controls.
Fifty-five glaucoma patients and 40 healthy controls were recruited from the Erlangen Glaucoma Registry for this study. Standard static white on white perimetry, 24-h IOP profile, stereographic optic disc slides, scanning laser polarimetry GDx VCC (Carl Zeiss Meditec, Inc., Dublin, CA) and optical coherence tomography (Spectralis HRA+OCT, Heidelberg Engineering, Germany) were performed in all patients and controls. For the controls only scans with TSS=100 were accepted. The glaucoma patients were divided into three subgroups according to their TSS (TSS=100; 99 ≥ TSS ≥ 80, TSS < 80). Receiver operating characteristic (ROC) curves were constructed for mean RNFL values, sector data and for the NFI. Sensitivity was estimated at ≥ 90% and ≥ 80% of specificity to compare the discriminating ability of each imaging modality.
For discrimination between healthy and glaucomatous eyes in GDx VCC the NFI demonstrated the largest area under the ROC curve (AUROC ± SE, Sensitivity at 90% Specificity; 0.996 ± 0.005;100%) for very typical scans (TSS of scans of both normals and perimetric glaucomas were TSS=100), followed by the inferotemporal sector (0.993 ± 0.007;100%) and the TSNIT average (0.985 ± 0.012;95%). In Spectralis-OCT the nasosuperior, inferotemporal sector, superior quarter showed the largest AUROC (1.000 ± 0.000;100%) followed by the TSNIT average (0.996 ± 0.005,100%). For atypical scans (TSS of glaucomatous scans were TSS < 80), in GDx VCC the NFI demonstrated the largest AUROC (0.954 ± 0.024;85%) followed by the supernasal sector (0.880 ± 0.050;65%) and the TSNIT average (0.645 ± 0.084;40%). In Spectralis-OCT the TSNIT average showed the largest AUROC (0.965 ± 0.033;95%) followed by the inferotemporal sector (0.955 ± 0.032,85%).
Low TSS is associated with a decrease in diagnostic accuracy for discriminating healthy and glaucomatous eyes in both GDx VCC and much less in Spectralis-OCT. Diagnostic accuracy of Spectralis-OCT was superior to GDx VCC for low TSS.
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