April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Comparison of the GDx GPA and the HRT TCA for Detection of Glaucomatous Progression
L. M. Alencar; M. Balasubramaniam; C. Bowd; R. N. Weinreb; L. M. Zangwill; P. A. Sample; F. A. Medeiros
Author Affiliations & Notes
  • L. M. Alencar
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
    Dep. of Ophtalmology, University of São Paulo, São Paulo, Brazil
  • M. Balasubramaniam
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
  • C. Bowd
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
  • R. N. Weinreb
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
  • L. M. Zangwill
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
  • P. A. Sample
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
  • F. A. Medeiros
    Hamilton Glaucoma Center, University of California San Diego, La Jolla, California
    Dep. of Ophtalmology, University of São Paulo, São Paulo, Brazil
  • Footnotes
    Commercial Relationships  L.M. Alencar, None; M. Balasubramaniam, None; C. Bowd, Lace Elettronica, F; R.N. Weinreb, Alcon laboratories, Inc., C; Allergan, Inc., C; Carl-Zeiss Meditec, Inc., C; Glaxo, C; Optovue, Inc., C; Pfizer, Inc., C; Topcon Medical Systems, Inc., C; Carl-zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Novartis, F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; L.M. Zangwill, Carl-zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; P.A. Sample, Carl-zeiss Meditec, Inc., F; Haag-Streit, F; Welch-Allyn, F; F.A. Medeiros, Alcon Laboratories, Inc., F; Carl-Zeiss Meditec, Inc., F; Pfizer, Inc., F; Alcon laboratories, Inc., C; Allergan, Inc., C; Pfizer, Inc., C; Alcon Laboratories, Inc., R; Allergan, Inc., R; Carl-Zeiss Meditec, Inc., R; Pfizer, Inc., R; Reicherts, Inc., R.
  • Footnotes
    Support  Supported in part by NEI R01-EY08208, NEI R01 11008, participant retention incentive grants in the form of glaucoma medication at no cost (Alcon Laboratories Inc., Allergan)
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4011. doi:
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      L. M. Alencar, M. Balasubramaniam, C. Bowd, R. N. Weinreb, L. M. Zangwill, P. A. Sample, F. A. Medeiros; Comparison of the GDx GPA and the HRT TCA for Detection of Glaucomatous Progression. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4011.

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Abstract

Purpose: : To evaluate the abilities of the GDx Guided Progression Analysis (GDx GPA) and the HRT Topographic Change Analysis (HRT TCA) to discriminate between stable eyes and eyes with glaucomatous progression determined using standard automated perimetry (SAP) and optic disc stereophotographs.

Methods: : We included 312 eyes of 202 individuals followed for an average of 4.04±1.15 years enrolled in the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). At baseline, 77 (25%) eyes had glaucoma with repeatable abnormal SAP, 202 (65%) were suspects (optic disc appearance and/or elevated intraocular pressure) and 33 (11%) were healthy. Visual field progression was evaluated by SAP Guided Progression Analysis. Optic disc progression was evaluated by masked assessment of serial stereophotographs. Progression by the HRT was evaluated using the TCA software conservative criterion (cluster of >= 2% of the disc area and depth of >=100µm). Progression by the GDx was evaluated using Variable Corneal Compensation (VCC) and the Fast Mode of the GDx GPA software.

Results: : During follow-up, 42 eyes (14%) progressed by stereophotographs and/or SAP. The GDx GPA detected 17 of these eyes (sensitivity 41%, positive likelihood ratio [LR] 6.9) and the HRT TCA detected 11 (sensitivity 26%, positive LR 2.6). Fourteen eyes showed progression only by the GDx (specificity for correctly classifying no progression in glaucomatous and suspect eyes 94%, negative LR 0.6), and 24 eyes showed progression only by the HRT (specificity 90%, negative LR 0.8). The GDx classified 2 healthy eyes as progressed (specificity for correctly classifying no progression in healthy eyes 94%), and the HRT classified none (specificity 100%). Comparison of the two tests showed no statistically significant difference (McNemar test, P=0.684).

Conclusions: : The GDx GPA and the HRT TCA were able to detect glaucomatous progression in a significant number of cases showing progression by conventional methods. Their high specificities suggest that these tests could be used as complementary tools for evaluation of change in glaucoma.

Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • optic disc • imaging/image analysis: clinical 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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