Department of Ophthalmology, Meram Medical Faculty, Selcuk University, Konya, Turkey.
Acta Ophthalmol. 2010 Feb;88(1):125-30. doi: 10.1111/j.1755-3768.2009.01591.x. Epub 2009 Jul 21.
This study aimed to evaluate the diagnostic accuracy of Moorfields regression analysis (MRA) and the glaucoma probability score (GPS) in primary open-angle glaucoma (POAG) and to measure the level of agreement between the two algorithms in classifying eyes as normal or abnormal in a Turkish population.
We prospectively selected 184 healthy subjects and 158 subjects with POAG, who underwent an ophthalmological examination, visual field analysis and imaging with the Heidelberg Retina Tomograph II, using HRT III software, Version 3.0. The diagnostic accuracies of the two classifications were measured when the borderline was taken as either normal (highest specificity criteria) or abnormal (highest sensitivity criteria). The agreement between them was calculated using the unweighted kappa (kappa) coefficient.
Optic nerve head topographic parameters showed statistically significant differences between the control and POAG groups (p < 0.001). The parameters with the highest area under the receiver operating characteristic curves were global GPS (0.86), cup : disc area (0.85), rim : disc area (0.85) and vertical cup : disc (0.85). According to the highest specificity criteria, MRA had a sensitivity of 67.7% and a specificity of 95.1%, whereas the GPS had a sensitivity of 70.9% and a specificity of 88.0%. According to the highest sensitivity criteria, MRA had a sensitivity of 81.0% and a specificity of 75.0%, whereas the GPS had a sensitivity of 89.2% and a specificity of 57.6%. A moderate agreement of 68% (233 eyes) with a kappa coefficient of 0.51 was found between MRA and the GPS.
The GPS automated classification showed similar sensitivity to MRA, but considerably lower specificity, when applied in a Turkish population.
本研究旨在评估 Moorfields 回归分析（MRA）和青光眼概率评分（GPS）在原发性开角型青光眼（POAG）中的诊断准确性，并测量两种算法在土耳其人群中对正常或异常眼分类的一致性程度。
我们前瞻性地选择了 184 名健康受试者和 158 名 POAG 受试者，他们接受了眼科检查、视野分析和 Heidelberg Retina Tomograph II 成像，使用 HRT III 软件，版本 3.0。当边界线取为正常（最高特异性标准）或异常（最高敏感性标准）时，测量了两种分类的诊断准确性。使用未加权 kappa（kappa）系数计算它们之间的一致性。
视乳头头部拓扑参数在对照组和 POAG 组之间显示出统计学上的显著差异（p < 0.001）。ROC 曲线下面积最高的参数是全局 GPS（0.86）、杯：盘面积（0.85）、边缘：盘面积（0.85）和垂直杯：盘（0.85）。根据最高特异性标准，MRA 的敏感性为 67.7%，特异性为 95.1%，而 GPS 的敏感性为 70.9%，特异性为 88.0%。根据最高敏感性标准，MRA 的敏感性为 81.0%，特异性为 75.0%，而 GPS 的敏感性为 89.2%，特异性为 57.6%。MRA 和 GPS 之间发现中度一致性为 68%（233 只眼），kappa 系数为 0.51。
在土耳其人群中应用时，GPS 自动分类的敏感性与 MRA 相似，但特异性明显较低。
