Rao Harsha L, Yadav Ravi K, Addepalli Uday K, Begum Viquar U, Senthil Sirisha, Choudhari Nikhil S, Garudadri Chandra S
*VST Glaucoma Center †Center for Clinical Epidemiology and Biostatistics, LV Prasad Eye Institute, Banjara Hills, Hyderabad, India.
J Glaucoma. 2015 Aug;24(6):e151-6. doi: 10.1097/IJG.0000000000000087.
To evaluate the relationship between the reference standard used to diagnose glaucoma and the diagnostic ability of spectral domain optical coherence tomograph (SDOCT).
In a cross-sectional study, 280 eyes of 175 consecutive subjects, referred to a tertiary eye care center for glaucoma evaluation, underwent optic disc photography, visual field (VF) examination, and SDOCT examination. The cohort was divided into glaucoma and control groups based on 3 reference standards for glaucoma diagnosis: first based on the optic disc classification (179 glaucoma and 101 control eyes), second on VF classification (glaucoma hemifield test outside normal limits and pattern SD with P-value of <5%, 130 glaucoma and 150 control eyes), and third on the presence of both glaucomatous optic disc and glaucomatous VF (125 glaucoma and 155 control eyes). Relationship between the reference standards and the diagnostic parameters of SDOCT were evaluated using areas under the receiver operating characteristic curve, sensitivity, and specificity.
Areas under the receiver operating characteristic curve and sensitivities of most of the SDOCT parameters obtained with the 3 reference standards (ranging from 0.74 to 0.88 and 72% to 88%, respectively) were comparable (P>0.05). However, specificities of SDOCT parameters were significantly greater (P<0.05) with optic disc classification as reference standard (74% to 88%) compared with VF classification as reference standard (57% to 74%).
Diagnostic parameters of SDOCT that was significantly affected by reference standard was the specificity, which was greater with optic disc classification as the reference standard. This has to be considered when comparing the diagnostic ability of SDOCT across studies.
评估用于诊断青光眼的参考标准与光谱域光学相干断层扫描（SDOCT）诊断能力之间的关系。
在一项横断面研究中，175名连续受试者的280只眼睛被转诊至三级眼科护理中心进行青光眼评估，这些眼睛接受了视盘照相、视野（VF）检查和SDOCT检查。根据青光眼诊断的3种参考标准，该队列被分为青光眼组和对照组：第一种基于视盘分类（179只青光眼眼和101只对照眼），第二种基于VF分类（青光眼半视野测试超出正常范围且模式标准差P值<5%，130只青光眼眼和150只对照眼），第三种基于青光眼性视盘和青光眼性VF两者均存在（125只青光眼眼和155只对照眼）。使用受试者操作特征曲线下面积、敏感性和特异性评估参考标准与SDOCT诊断参数之间的关系。
用3种参考标准获得的大多数SDOCT参数的受试者操作特征曲线下面积和敏感性（分别为0.74至0.88和72%至88%）具有可比性（P>0.05）。然而，与以VF分类作为参考标准（57%至74%）相比，以视盘分类作为参考标准时，SDOCT参数的特异性显著更高（P<0.05）（74%至88%）。
受参考标准显著影响的SDOCT诊断参数是特异性，以视盘分类作为参考标准时特异性更高。在比较不同研究中SDOCT的诊断能力时必须考虑这一点。
