Lauande-Pimentel R, Carvalho R A, Oliveira H C, Gonçalves D C, Silva L M, Costa V P
Glaucoma Service, Department of Ophthalmology, University of Campinas, Brazil.
Br J Ophthalmol. 2001 May;85(5):586-91. doi: 10.1136/bjo.85.5.586.
To evaluate the ability of structural parameters (as determined by retinal nerve fibre layer (RNFL) measurements obtained with the scanning laser polarimeter (SLP-NFA/GDx)) and functional parameters (as determined by automated perimetry) to discriminate between normal and glaucomatous eyes.
In a case-control study, a total of 91 normal subjects and 94 patients with glaucoma underwent automated perimetry and RNFL measurements obtained with the SLP. Three independent scans of each eye were obtained and a mean image was created and used for further analysis. Only one eye per individual was randomly included in the study. The sensitivity (Se) and specificity (Sp) of 12 RNFL parameters were calculated according to the SLP internal normative database. The Se and Sp of the visual field (VF) global indices and the glaucoma hemifield test (GHT) were also calculated according to the instrument's normative database. Receiver operator characteristic (ROC) curves were built for each SLP parameter and VF index. Fisher's linear discriminant formulas (LDFs) were developed for VF indices (VF LDF), SLP measurements (SLP LDF), and both examinations (combined LDF).
According to the SLP internal database, the parameters with better Se and Sp were: superior/nasal ratio (Se = 58.5%; Sp = 86.8%), and GDx the number (Se = 43.3%; Sp = 96.7%). The construction of an ROC curve for the number resulted in Se = 84% and Sp = 79%. The creation of LDFs improved both the sensitivities and specificities when compared with isolated parameters SLP LDF (Se = 90.4%; Sp = 82.4%), VF LDF (Se = 89.4%; Sp = 89.0%), and combined LDF (Se = 93.0%; Sp = 90.1%). The sensitivity to diagnose early and moderate glaucomatous damage observed with the GHT was lower than that obtained with the number (p < 0.01).
Creation of LDFs enhanced the Se and Sp for both VF and SLP. Integration of SLP and VF in a combined LDF reached the highest Se/Sp relation, suggesting that these examinations may be additive concerning the diagnosis of glaucoma. The SLP parameter the number may be more sensitive than the GHT in diagnosing early and moderate glaucomatous damage.
评估结构参数（通过扫描激光偏振仪（SLP-NFA/GDx）测量视网膜神经纤维层（RNFL）来确定）和功能参数（通过自动视野计测量来确定）区分正常眼和青光眼眼的能力。
在一项病例对照研究中，共有91名正常受试者和94名青光眼患者接受了自动视野计检查以及用SLP进行的RNFL测量。每只眼睛进行了三次独立扫描，并创建了一个平均图像用于进一步分析。每个个体仅随机纳入一只眼睛进行研究。根据SLP内部标准数据库计算12个RNFL参数的敏感性（Se）和特异性（Sp）。还根据仪器的标准数据库计算视野（VF）全局指数和青光眼半视野检测（GHT）的Se和Sp。为每个SLP参数和VF指数构建了受试者操作特征（ROC）曲线。为VF指数（VF线性判别公式（LDF））、SLP测量值（SLP LDF）以及两项检查（联合LDF）开发了Fisher线性判别公式。
根据SLP内部数据库，具有较好Se和Sp的参数为：上/鼻侧比值（Se = 58.5%；Sp = 86.8%），以及GDx数值（Se = 43.3%；Sp = 96.7%）。构建数值的ROC曲线得出Se = 84%，Sp = 79%。与单独参数相比，创建LDF提高了敏感性和特异性，SLP LDF（Se = 90.4%；Sp = 82.4%）、VF LDF（Se = 89.4%；Sp = 89.0%）和联合LDF（Se = 93.0%；Sp = 90.1%）。GHT对早期和中度青光眼性损害的诊断敏感性低于数值所获得的敏感性（p < 0.01）。
创建LDF提高了VF和SLP的Se和Sp。将SLP和VF整合到联合LDF中达到了最高的Se/Sp关系，表明这些检查在青光眼诊断方面可能具有相加作用。SLP参数数值在诊断早期和中度青光眼性损害方面可能比GHT更敏感。
