Comparing Computerized Matched FlickerTM Software With Stereo Disc Viewing to Detect Glaucoma Progression

Abstract

Purpose: : To compare expert and non-expert optic nerve head (ONH) photograph assessment with and without computerized alignment and presentation software (Matched Flicker^TM, EyeIC, Inc., Narberth, PA).

Methods: : This multicenter study involved glaucoma experts and non-experts at University of Florida, Wills Eye Institute, and University of Pittsburgh. Nine fellowship-trained glaucoma specialists and 9 general or in-training ophthalmologists each evaluated fundus photographs of 40-50 eyes by 2 different methods. Two ONH photographs of the same eye were captured at an average interval of three years. The first evaluation was done using the conventional photographic viewing and the second evaluation used Matched Flicker^TM alignment and presentation software. The ONH photos were assessed for disc rim thinning, hemorrhage, vessel movement on and off the disc, peripapillary atrophy change, and nerve fiber layer loss. The total evaluation time for each participant was measured. Change or stability was defined as agreement by 2 out of 3 glaucoma specialists or non-expert evaluators.

Results: : The glaucoma experts agreed 81% of the time between stereo viewing and Matched Flicker^TM and the residents 75% of the time. Non-glaucoma evaluator viewing time averaged 68 minutes per 40 slides with conventional ONH photo viewing versus 55 minutes with Matched Flicker^TM, and glaucoma specialists spent 45 minutes and 37 minutes respectively; however, conventional viewing always preceded Matched Flicker^TM. When comparing the responses for conventional viewing between experts and non-experts, there was 85% agreement. When comparing responses for Flicker viewing between experts and non-experts, there was 75% agreement.

Conclusions: : Matched Flicker^TM deserves further investigation as a tool for detecting changes in ONH photographs and glaucoma progression.

Keywords: imaging/image analysis: clinical • optic disc • clinical (human) or epidemiologic studies: systems/equipment/techniques