Andreou P A, Wickremasinghe S S, Asaria R H, Tay E, Franks W A
Glaucoma Service, Moorfield's Eye Hospital, London, UK.
Eye (Lond). 2007 Aug;21(8):1050-5. doi: 10.1038/sj.eye.6702394. Epub 2006 May 12.
To evaluate the performance of the HRT II (Heidelberg retinal tomograph) and GDx (glaucoma detection) retinal nerve fibre analyzer in GDx when used in the primary care eye clinic setting for glaucoma screening.
The study was prospective, cross-sectional, and hospital-based. One-hundred and twelve patients, 59 women and 53 men with a mean age of 57.8 years (range 18-85 years), had consecutive HRT II disc imaging and GDx retinal nerve fiber layer analysis. The Moorfield's regression classification and the 'GDx number' were used to predict the likelihood of glaucoma. A separate clinician, masked to the instrument results determined a definitive diagnosis, based on clinical examination. The extent of agreement between instrument prediction and the clinician diagnosis of glaucoma was examined by generating sensitivity and specificity tables.
The HRT II had a sensitivity of 0.79 (95% CI: 0.60-0.92) and a specificity of 0.70 (95% CI: 0.60-0.78). The positive predictive value of the HRT II was 0.43 (95% CI: 0.29-0.57). Using a GDx number of 50 as 'cutoff' for glaucoma detection, the GDx had a sensitivity of 0.80 (95% CI: 0.59-0.93) and a specificity of 0.72 (95% CI: 0.61-0.80), with a positive predictive value of 0.43 (95% CI: 0.28-0.59).
For glaucoma detection, neither the HRT II nor the GDx are effective as stand-alone screening devices in the primary care setting.
评估在基层眼科诊所环境中用于青光眼筛查时，HRT II（海德堡视网膜断层扫描仪）和GDx（青光眼检测仪）视网膜神经纤维分析仪的性能。
本研究为前瞻性、横断面、基于医院的研究。112例患者，其中59名女性和53名男性，平均年龄57.8岁（范围18 - 85岁），连续接受了HRT II视盘成像和GDx视网膜神经纤维层分析。使用穆尔菲尔德回归分类法和“GDx数值”来预测青光眼的可能性。另一位对仪器结果不知情的临床医生根据临床检查确定最终诊断。通过生成敏感度和特异度表来检查仪器预测与临床医生对青光眼诊断之间的一致性程度。
HRT II的敏感度为0.79（95%可信区间：0.60 - 0.92），特异度为0.70（95%可信区间：0.60 - 0.78）。HRT II的阳性预测值为0.43（95%可信区间：0.29 - 0.57）。以GDx数值50作为青光眼检测的“临界值”时，GDx的敏感度为0.80（95%可信区间：0.59 - 0.93），特异度为0.72（95%可信区间：0.61 - 0.80），阳性预测值为0.43（95%可信区间：0.28 - 0.59）。
对于青光眼检测，在基层医疗环境中，HRT II和GDx作为单独的筛查设备均无效。
