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G.C. Lindhorst, W.E. Sponsel, S. McKinnon, Y. Trigo, M. Pena; Comparative Analysis of Scanning Laser Topographic Indices Relative to Humphrey Visual Field and Simultaneous Stereo Disc Analysis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3393.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the ability of the HRT II (Heidelberg Engineering, Heidelberg, Germany) and the GDx Nerve Fiber Analyzer (Laser Diagnostic Technologies, San Diego, CA) to detect glaucoma. Methods: The study was conducted from 1998 through 2001 on attendees of the Veterans of Foreign Wars National Conventions. Participants underwent Frequency-Doubling perimetry (FDT) and Humphrey visual field (HVF24-2) testing. All subjects failing both FDT and HVF24-2 underwent disc imaging, as did a representative sample of subjects failing neither test, or the FDT only. Individuals were then separated into glaucomatous and non-glaucomatous populations based on a masked assessment of visual field and bilateral digital stereo disc images, by glaucoma specialists. Five parameters from the GDx (ellipse modulation, superior nasal, superior maximum, superior average, and GDx number) and HRT II (rim area, rim volume, cup shape measure, height variation contour, and mean RNFL thickness) were compared with the masked clinical evaluations. Results: 282 HRTII and/or GDx scans from 125 individuals (mean age 69) were assessed relative to concomitant, masked HVF 24-2 and dilated stereo disc analyses. The GDx and HRT II detected glaucoma with a sensitivity of 83% and 75%, respectively. The two devices designated as abnormal 50% and 66%, respectively, of those screened who were not deemed pathologic by masked HVF24-2/ analysis and stereo disc assessment. When considering those individuals who were deemed pathologic due to failure of the FDT screening only, the sensitivity for the GDX improved to 84%, and only 29% of those considered not pathologic were designated abnormal. The HRT data remained unchanged. Conclusion: The GDx and HRTII identified abnormalities in a high proportion of VFW-attendees confirmed as glaucomatous by clinical standards, and also designated as abnormal a substantial number of the veterans tested by scanning laser lacking confirmed cupping or visual field loss.
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