Clinical Assessment of Stereoscopic Optic Disc Photographs for Glaucoma: The European Optic Disc Assessment Trial

Reus, Nicolaas J.; Lemij, Hans G; Garway-Heath, David F.; Airaksinen, P. Juhani; Antón, Alfonso; Bron, Alain M.; Faschinger, Christoph; Holló, Gábor; Iester, Michele; Jonas, Jost B.; Mistlberger, Andrea; Topouzis, Fotis; Zeyen, Thierry

doi:10.1016/j.ophtha.2009.09.026

Cited by 128 publications

(130 citation statements)

References 19 publications

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“…As detection of glaucomatous ONH damage is frequently suboptimal, 24 evaluation of the diagnostic accuracy of the different imaging devices is of clinical importance. In the current study, we investigated the diagnostic capabilities of the RTVue-100 Fourier-domain OCT instrument on 286 Caucasian patients referred for glaucoma diagnostics to our centre during 11 months.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma

Garas

Vargha

Holló

2010

Eye

138

107

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Purpose To evaluate the diagnostic accuracy of retinal nerve fibre layer thickness (RNFLT), ganglion cell complex (GCC), and optic disc measurements made with the RTVue-100 Fourier-domain optical coherence tomography (OCT) to detect glaucoma in a Caucasian referral population. Methods One randomly selected eye of 286 Caucasian patients (93 healthy, 36 ocular hypertensive, 46 preperimetric glaucoma, and 111 perimetric glaucoma eyes) was evaluated. Results Using the software-provided classification, for the total population sensitivity did not exceed 73.6% for the optic nerve head parameters, and 62.7% for the other parameters. Specificity was high (94.6-100%) for most RNFLT and GCC parameters, but low (72.0-76.3%) for the optic disc parameters. Positive predictive value varied between 98.1 and 100% for the main RNFLT parameters, 92.6 and 100% for the 16 RNFLT sectors, 92.4 and 99.0% for the GCC parameters, but did not exceed 86.3% for any of the optic disc parameters. Positive likelihood ratio (PLR) was higher than 10 for average, inferior and superior RNFLT (25.5 to infinite), 12 of the 16 RNFLT sectors (12.6 to infinite), and three of the four GCC parameters (40.0 to 48.6). No optic disc parameter had a PLR higher than 3.0. Conclusions RNFLT and GCC parameters of the RTVue-100 Fourier-domain OCT showed moderate sensitive but high specificity, positive predictive value and PLR for detection of glaucoma. The optic disc parameters had lower diagnostic accuracy than the RNFLT and GCC parameters.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma

Garas

Vargha

Holló

2010

Eye

138

107

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“…Instead it supports the implementation of HRT in the daily clinical practice, as it has been recently shown that its diagnostic ability outperforms the diagnostic ability of general ophthalmologists. 66 Lastly, the results of the EGPS HRT substudy will contribute to the ongoing OHTS-EGPS HRT collaborative study with the aim of providing a further refinement of the risk model previously established by the collaboration of the 2 studies. 13,14 ALL AUTHORS HAVE COMPLETED AND SUBMITTED THE ICMJE FORM FOR DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST and report the following financial disclosures: S.M.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Heidelberg Retina Tomograph Parameters for the Development of Glaucoma in the European Glaucoma Prevention Study

Miglior

Zeyen

Torri

et al. 2015

American Journal of Ophthalmology

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PURPOSE: To determine whether baseline Heidelberg Retina Tomograph (HRT) measurements of the optic disc are associated with the development of open-angle glaucoma (OAG) in individuals with ocular hypertension in the European Glaucoma Prevention Study (EGPS).DESIGN: Retrospective analysis of a prospective, randomized, multicenter, double-masked, controlled clinical trial.METHODS: There were 489 participants in the HRT Ancillary Study to the EGPS. Each baseline HRT parameter was assessed in univariate and multivariate proportional hazards models to determine its association with the development of OAG. Proportional hazards models were used to identify HRT variables that predicted which participants in the EGPS had developed OAG. Development of OAG was based on visual field and/or optic disc changes.RESULTS: At a median follow-up time of about 5 years, 61 participants developed OAG. In multivariate analyses, adjusting for randomization arm, age, baseline IOP, central corneal thickness, pattern standard deviation, and HRT disc area, the following HRT parameters were associated with the development of OAG: the ''outside normal limits'' classification of the Frederick Mikelberg (FSM) discriminant function (hazard ratio [HR] 2.51, 95% confidence interval [CI]: 1.45-4.35), larger mean cup depth (HR 1.64, 95% CI: 1.21-2.23), cup-to-disc area ratio (HR 1.43, 95% CI: 1.14-1.80), linear cup-to-disc ratio (HR 1.43, 95% CI: 1.13-1.80), cup area (HR 1.33, 95% CI: 1.08-1.64), smaller rim area (HR 1.33, 95% CI: 1.07-1.64), larger cup volume (HR 1.30, 95% CI: 1.05-1.61), smaller rim volume (HR 1.25, 95% CI: 1.01-1.54), larger maximum cup depth (HR 1.18, 95% CI: 1.01-1.36), and cup shape measure (HR 1.18, 95% CI: 1.01-1.36).CONCLUSIONS: Several baseline HRT parameters, alone or in combination with baseline clinical and demographic factors, were significantly associated with the development of OAG among the EGPS participants. (Am J Ophthalmol 2015;159:265-276. Ó 2015 by Elsevier Inc. All rights reserved.)

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“…Structural changes due to glaucoma are usually detected by slit lamp fundoscopic examination or from assessment of stereophotographs; however, diagnosing early changes in this manner is challenging and subject to considerable disagreement even between expert observers ( Jampel et al, 2009;Reus et al, 2010).…”

Section: Detecting Structural Changementioning

confidence: 99%

“…Although the diagnosis of glaucoma is often straightforward, detection of early glaucoma can be challenging due to the wide variation in normal optic nerve head appearance. Subjective interpretation of optic disc stereophotographs is also subject to variation between and within observers, and there is at best moderate agreement even among expert observers ( Jampel et al, 2009;Reus et al, 2010).…”

mentioning

confidence: 99%

Strategies to improve early diagnosis in glaucoma

Tatham¹,

Medeiros²,

Zangwill³

et al. 2015

Progress in Brain Research

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Early diagnosis and treatment of glaucoma is important to reduce the risk of progressive and irreversible visual loss. The key to diagnosis is recognition of morphological changes to the optic nerve head and retinal nerve fiber layer, but in some patients, functional abnormalities are detected first. This review describes recent innovations with the potential to improve the early detection of glaucoma. Developments in imaging include novel optic nerve head metrics such as Bruch's membrane opening-minimum rim width, enhanced ability to quantify inner layers of the glaucomatous macula, and ability to image deep optic nerve head structures, including the lamina cribrosa. Developments in detection of early glaucomatous functional loss include novel perimetric tests using frequency-doubling technology and flicker-defined form stimuli. Methods to combine results of structural and functional assessments are also presented that may improve early detection of glaucoma. KeywordsGlaucoma, Optical coherence tomography, OCT, Perimetry, Spectral domain, Early diagnosis Glaucoma is a leading cause of blindness, affecting more than 70 million people worldwide, of whom approximately 10% are bilaterally blind (Quigley and Broman, 2006). Glaucomatous visual losses can be prevented with early diagnosis and treatment; however, affected individuals are typically asymptomatic until later stages of the disease and a large proportion of those affected remain undiagnosed. Population-level surveys suggest only 10-50% of people with glaucoma are aware that they have the condition and consequently there are a large number of people Progress in Brain Research, Volume 221, ISSN 0079-6123, http://dx

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Clinical Assessment of Stereoscopic Optic Disc Photographs for Glaucoma: The European Optic Disc Assessment Trial

Cited by 128 publications

References 19 publications

Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma

Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma

Predictive Value of Heidelberg Retina Tomograph Parameters for the Development of Glaucoma in the European Glaucoma Prevention Study

Strategies to improve early diagnosis in glaucoma

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