Ferreras Antonio, Pablo Luís E, Larrosa José M, Polo Vicente, Pajarín Ana B, Honrubia Francisco M
Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
Ophthalmology. 2008 May;115(5):775-781.e2. doi: 10.1016/j.ophtha.2007.06.032. Epub 2007 Sep 17.
To determine and validate the diagnostic ability of a linear discriminant function (LDF) based on global stereometric parameters obtained using the Heidelberg Retina Tomograph version 3 (HRT3) for discriminating between healthy eyes and eyes with glaucomatous visual field loss.
Cross-sectional study.
The authors prospectively selected 81 consecutive healthy subjects and 85 consecutive patients with open-angle glaucoma. Another prospective sample of 225 normal eyes and 210 glaucoma eyes was used to evaluate how well the LDF performed in another population.
Participants were divided into 2 groups depending on the results of standard automated perimetry and intraocular pressure. All participants underwent imaging of the optic nerve head with the HRT3.
The LDF was calculated according to the stepwise logistic regression results of global optic nerve head parameters and glaucoma probability score numerical values. The diagnostic accuracy of the LDF and other parameters included in the software of the HRT3 was evaluated in another independent population.
Based on the results of the stepwise binary logistic regression analysis, the function proposed was LDF = 8.23 - 8.00 x contour line modulation temporal superior + 9.41 x cup shape measure - 4.07 x rim area. The areas under the receiver operating characteristic curve were 0.875 for the LDF, 0.845 for the Frederick S. Mikelberg (FSM) discriminant function, and 0.838 for the Reinhard O. W. Burk (RB) discriminant function. There were no significant differences between these values. The LDF and the FSM and RB discriminant functions yielded sensitivities of 74.2%, 70.4%, and 67.6%, respectively, at a fixed specificity of 85%.
Compared with the HRT-provided parameters, the proposed LDF exhibited higher diagnostic ability than most available analyses. The LDF had a better sensitivity and specificity balance than the FSM and RB discriminant functions, regardless of optic disc size.
基于使用海德堡视网膜断层扫描仪3型（HRT3）获得的整体立体测量参数，确定并验证线性判别函数（LDF）区分健康眼睛和患有青光眼性视野缺损眼睛的诊断能力。
横断面研究。
作者前瞻性地选取了81名连续的健康受试者和85名连续的开角型青光眼患者。另一个包含225只正常眼睛和210只青光眼眼睛的前瞻性样本用于评估LDF在另一人群中的表现。
根据标准自动视野计和眼压测量结果将参与者分为两组。所有参与者均使用HRT3对视神经乳头进行成像。
根据整体视神经乳头参数和青光眼概率评分数值的逐步逻辑回归结果计算LDF。在另一个独立人群中评估LDF及HRT3软件中包含的其他参数的诊断准确性。
基于逐步二元逻辑回归分析结果，所提出的函数为LDF = 8.23 - 8.00×颞上轮廓线调制 + 9.41×杯状测量值 - 4.07×视盘面积。LDF的受试者工作特征曲线下面积为0.875，弗雷德里克·S·米克尔伯格（FSM）判别函数为0.845，莱因哈德·O·W·伯克（RB）判别函数为0.838。这些值之间无显著差异。在固定特异性为85%时，LDF以及FSM和RB判别函数的敏感性分别为74.2%、70.4%和67.6%。
与HRT提供的参数相比，所提出的LDF比大多数现有分析具有更高的诊断能力。无论视盘大小如何，LDF比FSM和RB判别函数具有更好的敏感性和特异性平衡。
