Department of Ophthalmology, Centre de Recherche de l'Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada.
Can J Ophthalmol. 2011 Jun;46(3):261-6. doi: 10.1016/j.jcjo.2011.05.008. Epub 2011 May 27.
To determine the utility of combining rim area to disc area asymmetry ratio (RADAAR) and Moorfields regression analysis (MRA) to detect primary open-angle glaucoma (POAG) using confocal scanning laser ophthalmoscopy (CSLO) (Heidelberg retina tomograph 3 (HRT3)) in high-risk populations.
Cross-sectional study.
Subjects with high risk for developing POAG.
Subjects underwent HRT, frequency doubling technology perimetry (FDT), and complete ophthalmic examination. Based on an ophthalmologic examination and FDT results of the worse eye, subjects were classified into 4 categories: normal, possible glaucoma, probable glaucoma, and definite glaucoma. Main outcome measures included sensitivities (Se), specificities (Sp), positive and negative predictive values (PPV, NPV), and positive and negative likelihood ratios (PLR, NLR) of the MRA, RADAAR, and combined MRA- RADAAR tests.
Of 375 subjects, 11 were classified as having definite glaucoma. Depending on the reference standard, range results for Se, Sp, PPV, NPV, PLR, and NLR were, respectively, 57.7% to 100%; 55.1% to 85.4%; 6.3% to 39%; 92.6% to 100%; 1.97 to 4.9; 0 to 0.49 for MRA; 11.5% to 27.3%; 98.1% to 98.8%; 30% to 60%; 87.4% to 97.8%; 9.29 to 14.1; and 0.74 to 0.89 for RADAAR; and 57.7% to 90.9%; 81.3% to 85.1%; 12.8% to 38.5%; 92.6% to 99.7%; 3.87 to 4.85; 0.11 to 0.50 for combination MRA-RADAAR.
When using HRT in populations at high risk for glaucoma, RADAAR had a higher specificity than MRA in identifying glaucoma. When patients were classified as borderline on MRA, combining RADAAR values decreased the number of false-positives as well, and may be recommended when high specificity is required.
利用共焦激光扫描检眼镜（海德堡视网膜断层扫描仪 3 型）下的盘沿面积与视盘面积比（RADAAR）和 Moorfields 回归分析（MRA）联合检测高危人群原发性开角型青光眼（POAG）。
横断面研究。
POAG 高危人群。
对受试者进行海德堡视网膜断层扫描仪检查、频域光相干断层扫描（FDT）和全面眼科检查。根据最差眼的眼科检查和 FDT 结果，将受试者分为 4 类：正常、可能青光眼、可疑青光眼和确诊青光眼。主要观察指标包括 MRA、RADAAR 及 MRA-RADAAR 联合检测的敏感度（Se）、特异度（Sp）、阳性和阴性预测值（PPV、NPV）及阳性和阴性似然比（PLR、NLR）。
375 例受试者中，11 例被诊断为确诊青光眼。根据参考标准，MRA 的 Se、Sp、PPV、NPV、PLR 和 NLR 范围分别为 57.7%～100%、55.1%～85.4%、6.3%～39%、92.6%～100%、1.97～4.9、0～0.49；RADAAR 的 Se、Sp、PPV、NPV、PLR 和 NLR 范围分别为 11.5%～27.3%、98.1%～98.8%、30%～60%、87.4%～97.8%、9.29～14.1、0.74～0.89；MRA-RADAAR 联合检测的 Se、Sp、PPV、NPV、PLR 和 NLR 范围分别为 57.7%～90.9%、81.3%～85.1%、12.8%～38.5%、92.6%～99.7%、3.87～4.85、0.11～0.50。
在高危青光眼人群中应用海德堡视网膜断层扫描仪时，RADAAR 比 MRA 具有更高的特异度，可以识别青光眼。当 MRA 检查结果为临界值时，联合 RADAAR 值可以减少假阳性的数量，在需要高特异性时可以推荐使用。
