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J. C. Yeh, A. Lu, R. Varma, D. Huang, Advanced Imaging for Glaucoma Study Group; Comparing the Glaucoma Diagnostic Accuracy of OCT, GDx, and HRT II Using Best Composite Scores. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3641.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the glaucoma diagnostic accuracy of optical coherence tomography (OCT, Stratus, Carl Zeiss Meditec, Inc.), Scanning laser polarimetry (SLP, GDx-ECC) and Scanning laser tomography (SLT, HRT II, Heidelberg Engineering).
A total of 307 eyes from 89 normal and 89 age-matched perimetric glaucoma participants in the Advanced Imaging for Glaucoma Study (AIGS) were evaluated. The diagnostic power was evaluated by the areas under the receiver operating characteristic (AROC). Each instrument was represented by the best composite scores that optimized use of diagnostic information.
For Stratus OCT, glaucoma was diagnosed if any of the following parameters were below cutoff: overall average, inferior quadrant, or superior quadrant retinal nerve fiber layer thickness. For GDx-ECC, the nerve fiber index (NFI) was used. For HRT II, the cup/area ratio was the best continuous parameter and the overall Moorfield regression analysis (MRA) was the best ordinal parameter. The AROC using continuous scale for OCT, GDx and HRT II, respectively, were 0.922, 0.852 and 0.844. OCT was significantly better than GDx (p=0.003) and HRT II (p=0.02). On the ordinal scale, the AROC values were 0.818, 0.790 and 0.817, for OCT, GDx-ECC and HRT II.
Stratus OCT has better diagnostic accuracy than GDx SLP and HRT II SLT. Although previous studies have shown the same trend, this is the first study to show a statistically significant difference between the 3 technologies. Compared to previous studies, our study is larger, and compared the best composite score rather than the best single parameter.
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