Diagnostic Ability of Heidelberg Retina Tomograph 3 Classifications

Ferreras, Antonio; Pajarín, Ana B.; Polo, Vicente; Larrosa, José M.; Pablo, L.; Fm, Honrubia

doi:10.1016/j.ophtha.2007.01.015

Cited by 57 publications

(23 citation statements)

References 25 publications

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“…7 Importantly, the sensitivity of the ISNT rule in our study and the earlier study 7 is higher than other current HRT diagnostic algorithms (i.e., MRA, GPS, and Mikelberg, Burk, and Bathija linear discriminant functions, which have reported sensitivities of ,90% in clinic-and population-based studies). 16,17,19,30,32,33 Thus, the high sensitivity and NPV of the ISNT rule per se revealed in our analysis indicated potential utility in population-based glaucoma evaluation.…”

Section: Discussionmentioning

confidence: 57%

“…In addition, disc size is known to influence the diagnostic performance of HRT classification algorithms, such as the Moorfields regression analysis (MRA), glaucoma probability score (GPS), and linear discriminant functions. [16][17][18][19] Whether the performance of the ISNT rule on the HRT is influenced by the spectrum of optic disc sizes in the population is unclear. Therefore, a second objective of this study was to evaluate the impact of disc area on the performance of the ISNT rule and its variants.…”

Section: Superior (S) Nasal (N)mentioning

confidence: 99%

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Diagnostic Performance of the ISNT Rule for Glaucoma Based on the Heidelberg Retinal Tomograph

Chan¹,

Liao²,

Foo³

et al. 2013

Trans. Vis. Sci. Tech.

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Purpose: We determined the accuracy of the inferior . superior . nasal . temporal (ISNT) neuroretinal rim area rule and its variants in adult Asian populations, and evaluated whether disc area impacts its performance characteristics.Methods: Participants in the Singapore Malay Eye Study (SiMES) and Singapore Indian Eye Study (SINDI) underwent standardized ocular examinations, including optic disc imaging with the Heidelberg retinal tomograph (HRT). Glaucoma was defined using the ISGEO criteria. HRT rim areas in the superior, inferior, nasal, and temporal quadrants were quantified. We determined sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of violating the ISNT rule and 4 variants (I . S . T, I . S, I . T, and combined I . T and S . T). The influence of disc area was analyzed with multivariate marginal logistic regression.Results: There were 6112 participants (mean age: 57.6 6 10.3 years). Glaucoma was present in 194 individuals (3.2%). Among 11,840 eyes, 232 (93.2%) of 249 glaucomatous eyes and 9768 (84.3%) of 11,591 nonglaucomatous eyes, violated the ISNT rule. The ISNT rule had highest sensitivity (93.5%), but lowest specificity (15.7%); I . T had highest specificity (98.2%), but low sensitivity (7.4%). For all variants, PPVs were low (2.1%-8.4%) and NPVs were high (97.9-99.1%). Larger disc area was associated with reduced specificity for the ISNT rule (P , 0.001), and reduced sensitivity (P ¼ 0.01) and increased specificity for I . S . T (P , 0.05). PPV increased (P , 0.05) and NPV decreased (P , 0.001) with increasing disc area. Conclusions:The ISNT rule based on HRT has high sensitivity, and the I . T, S . T, and combined I . T and S . T variants have high specificity. Disc area influences sensitivity, specificity, PPV, and NPV of the ISNT rule and its variants.Translational Relevance: The high sensitivity of the ISNT rule, and high specificities of its variants, may have potential utility when used in combination with other HRT algorithms for glaucoma assessment.

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Section: Discussionmentioning

confidence: 57%

Section: Superior (S) Nasal (N)mentioning

confidence: 99%

Diagnostic Performance of the ISNT Rule for Glaucoma Based on the Heidelberg Retinal Tomograph

Chan¹,

Liao²,

Foo³

et al. 2013

Trans. Vis. Sci. Tech.

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“…Ferreras et al [13] reported lower sensitivities of both algorithms in early glaucomatous eyes, especially for MRA [10]. Higher diagnostic accuracies were seen in cases of advanced visual loss and glaucoma severity, for both MRA and GPS [14].…”

Section: Discussionmentioning

confidence: 99%

“…Direct population comparison is difficult as majority of the studies are done in Caucasian populations [13, 15-18]. Coops et al [15] studied 95 Caucasian healthy controls (mean deviation of -0.1 decibels, range +2.5 to -3.7) and 121 Caucasian glaucoma patients (mean deviation of -3.6 decibels, range +2.0 to -9.9).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ethnic-specific Databases in Heidelberg Retina Tomography-3 to Discriminate Between Early Glaucoma and Normal Chinese Eyes

Tan

Yap

et al. 2017

TOOPHTJ

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Purpose:To compare the diagnostic accuracy of the 3 race-specific normative databases in Heidelberg Retina Tomography (HRT)-3, in differentiating between early glaucomatous and healthy normal Chinese eyes.Method:52 healthy volunteers and 25 glaucoma patients were recruited for this prospective cross-sectional study. All underwent standardized interviews, ophthalmic examination, perimetry and HRT optic disc imaging. Area under the curve (AUC) receiver operating characteristics, sensitivity and specificity were derived to assess the discriminating abilities of the 3 normative databases, for both Moorfields Regression Analysis (MRA) and Glaucoma Probability Score (GPS).Results:A significantly higher percentage (65%) of patients were classified as “within normal limits” using the MRA-Indian database, as compared to the MRA-Caucasian and MRA-African-American databases. However, for GPS, this was observed using the African-American database. For MRA, the highest sensitivity was obtained with both Caucasian and African-American databases (68%), while the highest specificity was from the Indian database (94%). The AUC for discrimination between glaucomatous and normal eyes by MRA-Caucasian, MRA-African-American and MRA-Indian databases were 0.77 (95% CI, 0.67-0.88), 0.79 (0.69-0.89) and 0.73 (0.63-0.84) respectively. For GPS, the highest sensitivity was obtained using either Caucasian or Indian databases (68%). The highest specificity was seen with the African-American database (98%). The AUC for GPS-Caucasian, GPS-African-American and GPS-Indian databases were 0.76 (95% CI, 0.66-0.87), 0.77 (0.67-0.87) and 0.76 (0.66-0.87) respectively.Conclusion:Comparison of the 3 ethnic databases did not reveal significant differences to differentiate early glaucomatous from normal Chinese eyes.

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“…30 HRT could outperform stereophotography in one study, but the authors used non-mydriatic stereophotographs, which are not of optimum quality. 31 The diagnostic performance of MRA compared with GPS was judged to be similar in some studies, 32,33 while others reported a better performance of GPS 34 or MRA. 35 Regarding SLP (GDx), two high-quality studies were detected (i.e.…”

Section: Literature Reviewmentioning

confidence: 97%

Imaging Technologies for the Diagnosis of Glaucoma

Bochmann¹,

Azuara‐Blanco²

2009

European Ophthalmic Review

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In this article we describe recent advances in imaging technologies that quantify the topography of the optic nerve head and retinal nerve fibre layer and their role in diagnosing glaucoma. These technologies include optical coherence tomography (OCT), scanning laser polarimetry (SLP, GDx) and confocal scanning laser ophthalmoscopy (CSLO, HRT). A review of recently published literature was carried out.The diagnostic performance of the different imaging devices is comparable and appears to be acceptable for the diagnosis of manifest glaucoma. The benefits of recent technological improvements need to be fully assessed. At the moment it is not clear which of the currently used imaging technologies is the most useful for diagnosis and management of glaucoma. KeywordsOptical coherence tomography, scanning laser polarimetrey, confocal scanning laser ophthalmoscopy ) and optical coherence tomography (OCT) (see Figure 1). They can be used to detect early structural damage by focusing on glaucoma-relevant structures of the ONH and surrounding tissues and using a normative database to determine the probability of glaucoma. Imaging of the ONH and the RNFL for detecting glaucoma progression is another important aspect of glaucoma management. However, in this review we will focus only on the role of imaging technologies in the diagnosis of glaucoma.We will provide a brief description of the recent advances, and review the current literature on the diagnostic performance for glaucoma of these imaging devices. Scanning Laser PolarimetrySLP is designed to provide objective assessment of the RNFL thickness with potential use for diagnosis and follow-up. SLP is based on the principle that polarised light passing through the birefringence RNFL undergoes a detectable phase shift, which is linearly related to RNFL thickness. 7 The result is a 2D map of retardation around the optic disc. The software provides a discriminating classifier of glaucoma/normality named nerve fibre indicator (NFI), which is fully automated. To detect change over time, regression analysis can be performed.The first GDx nerve fibre analyser contained a fixed compensating device to compensate for polarisation effects of cornea and lens.

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Diagnostic Ability of Heidelberg Retina Tomograph 3 Classifications

Cited by 57 publications

References 25 publications

Diagnostic Performance of the ISNT Rule for Glaucoma Based on the Heidelberg Retinal Tomograph

Diagnostic Performance of the ISNT Rule for Glaucoma Based on the Heidelberg Retinal Tomograph

Comparison of Ethnic-specific Databases in Heidelberg Retina Tomography-3 to Discriminate Between Early Glaucoma and Normal Chinese Eyes

Imaging Technologies for the Diagnosis of Glaucoma

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