Tan Xiu Ling, Yap Sae Cheong, Li Xiang, Yip Leonard W
Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore.
Ministry of Health Holdings, Singapore.
Open Ophthalmol J. 2017 Feb 28;11:40-46. doi: 10.2174/1874364101711010040. eCollection 2017.
To compare the diagnostic accuracy of the 3 race-specific normative databases in Heidelberg Retina Tomography (HRT)-3, in differentiating between early glaucomatous and healthy normal Chinese eyes.
52 healthy volunteers and 25 glaucoma patients were recruited for this prospective cross-sectional study. All underwent standardized interviews, ophthalmic examination, perimetry and HRT optic disc imaging. Area under the curve (AUC) receiver operating characteristics, sensitivity and specificity were derived to assess the discriminating abilities of the 3 normative databases, for both Moorfields Regression Analysis (MRA) and Glaucoma Probability Score (GPS).
A significantly higher percentage (65%) of patients were classified as "within normal limits" using the MRA-Indian database, as compared to the MRA-Caucasian and MRA-African-American databases. However, for GPS, this was observed using the African-American database. For MRA, the highest sensitivity was obtained with both Caucasian and African-American databases (68%), while the highest specificity was from the Indian database (94%). The AUC for discrimination between glaucomatous and normal eyes by MRA-Caucasian, MRA-African-American and MRA-Indian databases were 0.77 (95% CI, 0.67-0.88), 0.79 (0.69-0.89) and 0.73 (0.63-0.84) respectively. For GPS, the highest sensitivity was obtained using either Caucasian or Indian databases (68%). The highest specificity was seen with the African-American database (98%). The AUC for GPS-Caucasian, GPS-African-American and GPS-Indian databases were 0.76 (95% CI, 0.66-0.87), 0.77 (0.67-0.87) and 0.76 (0.66-0.87) respectively.
Comparison of the 3 ethnic databases did not reveal significant differences to differentiate early glaucomatous from normal Chinese eyes.
比较海德堡视网膜断层扫描(HRT)-3中3个种族特异性标准数据库在鉴别早期青光眼性和健康正常中国人眼方面的诊断准确性。
招募52名健康志愿者和25名青光眼患者进行这项前瞻性横断面研究。所有受试者均接受标准化访谈、眼科检查、视野检查和HRT视盘成像。采用曲线下面积(AUC)、受试者操作特征、敏感性和特异性来评估3个标准数据库对 Moorfields回归分析(MRA)和青光眼概率评分(GPS)的鉴别能力。
与MRA-白种人和MRA-非裔美国人数据库相比,使用MRA-印度人数据库时,被归类为“正常范围”的患者比例显著更高(65%)。然而,对于GPS,这一情况出现在使用非裔美国人数据库时。对于MRA,白种人和非裔美国人数据库的敏感性最高(68%),而特异性最高的是印度人数据库(94%)。MRA-白种人、MRA-非裔美国人和MRA-印度人数据库鉴别青光眼性和正常眼的AUC分别为0.77(95%CI,0.67 - 0.88)、0.79(0.69 - 0.89)和0.73(0.63 - 0.84)。对于GPS,使用白种人或印度人数据库时敏感性最高(68%)。非裔美国人数据库的特异性最高(98%)。GPS-白种人、GPS-非裔美国人和GPS-印度人数据库的AUC分别为0.76(95%CI,0.66 - 0.87)、0.77(0.67 - 0.87)和0.76(0.66 - 0.87)。
3个种族数据库的比较未显示出在鉴别早期青光眼性中国人眼和正常中国人眼方面存在显著差异。