Department of Ophthalmology, Miguel Servet University Hospital, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
Eye (Lond). 2010 Jan;24(1):123-30. doi: 10.1038/eye.2009.14. Epub 2009 Feb 13.
To evaluate and compare the diagnostic accuracy of the Heidelberg retina tomograph (HRT) version 3 with that of glaucoma specialists using stereophotography in discriminating between normal eyes and patients with early glaucomatous visual field loss.
A total of 105 eyes of 105 individuals were prospectively and consecutively recruited. The sample comprised 51 normal and 54 early glaucomatous eyes, as defined by intraocular pressure and standard automated perimetry results, regardless of optic disc appearance. Receiver operating characteristic (ROC) curves were plotted for the HRT3 parameters and a linear discriminant function (LDF) developed in our hospital. Best sensitivity-specificity pairs were compared between the HRT3 parameters, with the highest areas under the ROC curve (AUCs) and evaluation of optic disc stereophotographs. Agreement between methods for measuring vertical cup-to-disc ratio was evaluated with the Bland-Altman plot.
The average visual field mean deviation was -2.90 dB. The HRT3 parameters with the largest AUCs were our LDF (0.900), rim volume (0.883), and vertical cup/disk ratio (0.880), with no significant differences between these parameters. Sensitivity-specificity pairs were 79.6-100% (clinical evaluation), 83.3-86.3% (our LDF), 64.8-96.1% (final glaucoma probability score), and 68.5-90.2% (global Moorfields regression analysis).
The diagnostic accuracy for differentiating normal eyes from those with early visual field defects was similar between clinical evaluation of the optic disc and evaluation with the HRT3. The use of our LDF increased the sensitivity-specificity balance with respect to the HRT-provided parameters. The diagnostic accuracy of the HRT classifications was comparable to that of an experienced glaucoma specialist.
评估海德堡视网膜断层扫描仪（HRT）第 3 版与使用立体摄影术的青光眼专家在区分正常眼和早期青光眼视野缺损患者方面的诊断准确性。
前瞻性连续招募了 105 名 105 名个体的 105 只眼。该样本包括 51 只正常眼和 54 只早期青光眼眼，根据眼内压和标准自动视野计结果定义，无论视盘外观如何。为 HRT3 参数绘制了受试者工作特征（ROC）曲线，并开发了我们医院的线性判别函数（LDF）。比较了 HRT3 参数之间的最佳灵敏度-特异性对，比较了 ROC 曲线下面积（AUCs）最高的参数，并评估了视盘立体摄影图。使用 Bland-Altman 图评估了两种方法测量垂直杯盘比的一致性。
平均视野平均偏差为-2.90 dB。ROC 曲线下面积最大的 HRT3 参数是我们的 LDF（0.900）、边缘体积（0.883）和垂直杯/盘比（0.880），这些参数之间没有显著差异。灵敏度-特异性对分别为 79.6-100%（临床评估）、83.3-86.3%（我们的 LDF）、64.8-96.1%（最终青光眼概率评分）和 68.5-90.2%（全球 Moorfields 回归分析）。
临床评估视盘与 HRT3 评估区分正常眼与早期视野缺损眼的诊断准确性相似。使用我们的 LDF 增加了 HRT 提供的参数的灵敏度-特异性平衡。HRT 分类的诊断准确性与经验丰富的青光眼专家相当。
