De León-Ortega Julio E, Sakata Lisandro M, Monheit Blythe E, McGwin Gerald, Arthur Stella N, Girkin Christopher A
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
Am J Ophthalmol. 2007 Oct;144(4):525-32. doi: 10.1016/j.ajo.2007.06.021. Epub 2007 Aug 13.
To compare the diagnostic accuracy of the Moorfields regression analysis (MRA), parameters, and glaucoma probability score (GPS) from Heidelberg Retinal Tomograph (HRT) 3 (Heidelberg Engineering, Heidelberg, Germany) with MRA and parameters from HRT II in discriminating glaucomatous and healthy eyes in subjects of African and European ancestry.
Case-control institutional setting.
Seventy-eight glaucoma patients (44 of African ancestry, 34 of European ancestry) and 89 age-matched controls (46 of African ancestry, 33 European ancestry), defined by visual fields and self-reported race were included. Imaging was obtained with HRT II, and data were exported to a computer with the HRT 3 software using the same contour line. Area under the receiver operating characteristic (ROC) curves (AUCs), sensitivity, and specificity were evaluated for the entire group, the African ancestry group, and the European ancestry group separately. Mean disk area was compared between correctly and incorrectly diagnosed eyes by each technique.
Disk, cup, and rim areas from HRT 3 were lower than HRT II (P < .0001). AUC (sensitivity at 95% specificity) was 0.85 (54%) for vertical cup-to-disk ratio (VCDR) HRT 3, 0.84 (45%) for VCDR HRT II, and 0.81 (44%) for GPS at the temporal sector. MRA HRT 3 showed greater sensitivity but lower specificity than HRT II for the entire group, the African ancestry group, and the European ancestry group. GPS classification had the lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller mean disk area (P = .0002); control eyes incorrectly classified had greater mean disk area (P = .015).
VCDR from HRT 3 showed higher sensitivity than HRT II and GPS for the entire group and for those of African ancestry and of European ancestry separately. Sensitivity of MRA improved in HRT 3 with some trade-off in specificity compared with MRA of HRT II. GPS yielded erroneous classification associated to optic disk size.
比较德国海德堡海德堡工程公司生产的海德堡视网膜断层扫描仪（HRT）3的 Moorfields 回归分析（MRA）、参数和青光眼概率评分（GPS）与 HRT II 的 MRA 和参数在区分非洲和欧洲血统受试者的青光眼性眼和健康眼中的诊断准确性。
病例对照机构研究。
纳入 78 例青光眼患者（44 例非洲血统，34 例欧洲血统）和 89 例年龄匹配的对照者（46 例非洲血统，33 例欧洲血统），根据视野和自我报告的种族进行定义。使用 HRT II 进行成像，并使用相同的轮廓线将数据导出到装有 HRT 3 软件的计算机上。分别对整个组、非洲血统组和欧洲血统组评估受试者操作特征（ROC）曲线下面积（AUC）、敏感性和特异性。通过每种技术比较正确和错误诊断的眼睛之间的平均视盘面积。
HRT 3 的视盘、视杯和视盘边缘面积低于 HRT II（P <.0001）。垂直杯盘比（VCDR）HRT 3 的 AUC（95%特异性时的敏感性）为 0.85（54%），VCDR HRT II 为 0.84（45%），颞侧扇形区的 GPS 为 0.81（44%）。对于整个组、非洲血统组和欧洲血统组，MRA HRT 3 显示出比 HRT II 更高的敏感性但更低的特异性。GPS 分类的特异性最低。被 GPS 错误分类的青光眼性眼的平均视盘面积较小（P =.0002）；被错误分类的对照眼的平均视盘面积较大（P =.015）。
HRT 3 的 VCDR 在整个组以及分别在非洲血统和欧洲血统的人群中显示出比 HRT II 和 GPS 更高的敏感性。与 HRT II 的 MRA 相比，HRT 3 中 MRA 的敏感性有所提高，但在特异性方面有所权衡。GPS 产生与视盘大小相关的错误分类。
