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M. Michelessi, F. Oddone, M. Centofanti, M. Iester, P. Fogagnolo, L. Rossetti, E. Capris, G. L. Manni, G. Cupo; Diagnostic Accuracy of Sectorial Analysis of Optic Nerve Head Morphology Using the Heidelberg Retinal Tomograph 3. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3636. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the ability of the sectorial optic nerve head (ONH) parameters measured by Heidelberg Retinal Tomograph 3 (HRT3) to discriminate between healthy and glaucomatous eyes and to determine whether they are affected by disc size and glaucoma severity.
233 eyes from 137 normal subjects and 99 glaucomatous patients were enrolled. All patients underwent a full eye examination, standard achromatic perimetry (SAP) and imaging with HRT3. Glaucoma was defined on the basis of SITA-24-2 visual field loss (PSD p<5% and Glaucoma Hemifield Test outside normal limits) on two consecutive visual fields. The area under the Receiver Operating Characteristics curves (AUC) for continuos parameters, sensitivity(Sn), specificity (Sp), positive and negative predictive values (PPV, NPV) for dichotomous parameters, were respectively used as measures of diagnostic accuracy. The analysis was performed for each ONH sector in the whole sample population and repeated after stratification for optic disc size and glaucoma severity.
The best discriminatory parameters were found in the infero-temporal sector with the Cup/Disc area ratio showing the largest AUC (0.74), Moorfields Regression Analysis (MRA) showing 63% Sn and 88% Sp, Glaucoma Probability Score (GPS) showing 80% Sn and 62% Sp. Rim Area in the infero-temporal sector showed the largest AUC (0.68) in the earlier stages of the disease while Cup/Disc area ratio in the supero-temporal sector showed the largest AUC in the more advanced stages (0.87). Mean RNFL in the infero-temporal sector showed the largest AUC in small discs (0.83), Cup/Disc area ratio in the infero-temporal sector showed the largest AUC in medium discs (0.73), and Cup Shape Measure (CSM) in the supero-temporal sector showed the higher AUC in large discs(0.79).
Temporal-inferior and temporal-superior ONH sectors offer the best HRT3 sectorial discriminatory parameters across different ONH sizes and glaucoma stages.
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