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D. Sinapis, A. Sinapis, C. Bergin, R. Moosavi, R. A. Russell, G. M. Verdon-Roe, C. Balian, J. Flanagan, D. P. Crabb, D. F. Garway-Heath; Perimetry Instrument Comparison Study: Comparing the Diagnostic Performance of Four Threshold Perimetry Tests to Discriminate Between Healthy and ‘Glaucomatous’ Eyes (Interim Analysis). Invest. Ophthalmol. Vis. Sci. 2010;51(13):5504. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To consider interim results of the relative diagnostic performance of four threshold tests to discriminate between healthy and ‘glaucomatous’ eyes, defined by neuroretinal rim loss and intraocular pressure (IOP) level.
One hundred and thirty-six from a planned 320 participants have been recruited and tested in a four centre study of perimetry instruments (mean age=58, range 18 to 83 years). Patient selection criteria were: (i) Heidelberg Retina Tomograph (HRT) Moorfields Regression Analysis (MRA) ‘Outside Normal Limits’; rim area >0.5mm2 and (ii) IOP >21mmHg at referral; <26mmHg at time of testing. Healthy subjects had HRT MRA ‘Within Normal Limits’ and IOP ≤21mmHg. Thus, the reference standard for ‘glaucoma’ was independent of perimetry. One eye of each subject was tested on Standard Automated Perimetry (SAP, 24-2 SITA standard), Frequency Doubling Technology Perimetry (FDT, 24-2 ZEST), Heidelberg Edge Perimetry (HEP, 24-2 ASTA standard) and the Moorfields Motion Displacement Test (MDT, WEBS); order randomized and unreliable tests (false positive rate >15%) were repeated once. Sensitivity and specificity for different numbers of significantly depressed points (P <5%) were recorded. The areas under the receiver operating characteristic curves (AUC) were computed.
At approximately 95% specificity, the sensitivities were: SAP 32% (95% confidence interval [CI]: 23 to 43%); HEP 38% (95% CI: 28 to 49%); FDT 46% (95% CI: 35 to 56%); MDT 32% (95% CI: 23 to 43%). The AUCs were: SAP 73% (95% CI: 68 to 78%); HEP 79% (95% CI: 74 to 84%); FDT 77% (95% CI: 72 to 82%); MDT 72% (95% CI: 66 to 77%).
The diagnostic performance of each of the four tests was similar in this group with very early glaucoma.Acknowledgement of collaborators: L.Tanga, M.Michelessi, F.Oddone (Bietti Foundation, Rome, Italy), G.Sharpe, P.Artes (Dalhousie University, Halifax, NS, Canada).
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