Comparison of Diagnostic Accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to Discriminate Glaucomatous and Nonglaucomatous Eyes

Purpose To compare the diagnostic accuracy of the Moorfields regression analysis (MRA), parameters, and glaucoma probability score (GPS) from Heidelberg Retinal Tomograph (HRT) 3 (Heidelberg Engineering, Heidelberg, Germany) with MRA and parameters from HRT II in discriminating glaucomatous and heal...

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Veröffentlicht in:American journal of ophthalmology 2007-10, Vol.144 (4), p.525-532.e1
Hauptverfasser: De León-Ortega, Julio E, Sakata, Lisandro M, Monheit, Blythe E, Mcgwin, Gerald, Arthur, Stella N, Girkin, Christopher A
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container_end_page 532.e1
container_issue 4
container_start_page 525
container_title American journal of ophthalmology
container_volume 144
creator De León-Ortega, Julio E
Sakata, Lisandro M
Monheit, Blythe E
Mcgwin, Gerald
Arthur, Stella N
Girkin, Christopher A
description Purpose To compare the diagnostic accuracy of the Moorfields regression analysis (MRA), parameters, and glaucoma probability score (GPS) from Heidelberg Retinal Tomograph (HRT) 3 (Heidelberg Engineering, Heidelberg, Germany) with MRA and parameters from HRT II in discriminating glaucomatous and healthy eyes in subjects of African and European ancestry. Design Case-control institutional setting. Methods Seventy-eight glaucoma patients (44 of African ancestry, 34 of European ancestry) and 89 age-matched controls (46 of African ancestry, 33 European ancestry), defined by visual fields and self-reported race were included. Imaging was obtained with HRT II, and data were exported to a computer with the HRT 3 software using the same contour line. Area under the receiver operating characteristic (ROC) curves (AUCs), sensitivity, and specificity were evaluated for the entire group, the African ancestry group, and the European ancestry group separately. Mean disk area was compared between correctly and incorrectly diagnosed eyes by each technique. Results Disk, cup, and rim areas from HRT 3 were lower than HRT II ( P < .0001). AUC (sensitivity at 95% specificity) was 0.85 (54%) for vertical cup-to-disk ratio (VCDR) HRT 3, 0.84 (45%) for VCDR HRT II, and 0.81 (44%) for GPS at the temporal sector. MRA HRT 3 showed greater sensitivity but lower specificity than HRT II for the entire group, the African ancestry group, and the European ancestry group. GPS classification had the lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller mean disk area ( P = .0002); control eyes incorrectly classified had greater mean disk area ( P = .015). Conclusions VCDR from HRT 3 showed higher sensitivity than HRT II and GPS for the entire group and for those of African ancestry and of European ancestry separately. Sensitivity of MRA improved in HRT 3 with some trade-off in specificity compared with MRA of HRT II. GPS yielded erroneous classification associated to optic disk size.
doi_str_mv 10.1016/j.ajo.2007.06.021
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Design Case-control institutional setting. Methods Seventy-eight glaucoma patients (44 of African ancestry, 34 of European ancestry) and 89 age-matched controls (46 of African ancestry, 33 European ancestry), defined by visual fields and self-reported race were included. Imaging was obtained with HRT II, and data were exported to a computer with the HRT 3 software using the same contour line. Area under the receiver operating characteristic (ROC) curves (AUCs), sensitivity, and specificity were evaluated for the entire group, the African ancestry group, and the European ancestry group separately. Mean disk area was compared between correctly and incorrectly diagnosed eyes by each technique. Results Disk, cup, and rim areas from HRT 3 were lower than HRT II ( P &lt; .0001). AUC (sensitivity at 95% specificity) was 0.85 (54%) for vertical cup-to-disk ratio (VCDR) HRT 3, 0.84 (45%) for VCDR HRT II, and 0.81 (44%) for GPS at the temporal sector. MRA HRT 3 showed greater sensitivity but lower specificity than HRT II for the entire group, the African ancestry group, and the European ancestry group. GPS classification had the lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller mean disk area ( P = .0002); control eyes incorrectly classified had greater mean disk area ( P = .015). Conclusions VCDR from HRT 3 showed higher sensitivity than HRT II and GPS for the entire group and for those of African ancestry and of European ancestry separately. Sensitivity of MRA improved in HRT 3 with some trade-off in specificity compared with MRA of HRT II. 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Design Case-control institutional setting. Methods Seventy-eight glaucoma patients (44 of African ancestry, 34 of European ancestry) and 89 age-matched controls (46 of African ancestry, 33 European ancestry), defined by visual fields and self-reported race were included. Imaging was obtained with HRT II, and data were exported to a computer with the HRT 3 software using the same contour line. Area under the receiver operating characteristic (ROC) curves (AUCs), sensitivity, and specificity were evaluated for the entire group, the African ancestry group, and the European ancestry group separately. Mean disk area was compared between correctly and incorrectly diagnosed eyes by each technique. Results Disk, cup, and rim areas from HRT 3 were lower than HRT II ( P &lt; .0001). AUC (sensitivity at 95% specificity) was 0.85 (54%) for vertical cup-to-disk ratio (VCDR) HRT 3, 0.84 (45%) for VCDR HRT II, and 0.81 (44%) for GPS at the temporal sector. MRA HRT 3 showed greater sensitivity but lower specificity than HRT II for the entire group, the African ancestry group, and the European ancestry group. GPS classification had the lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller mean disk area ( P = .0002); control eyes incorrectly classified had greater mean disk area ( P = .015). Conclusions VCDR from HRT 3 showed higher sensitivity than HRT II and GPS for the entire group and for those of African ancestry and of European ancestry separately. Sensitivity of MRA improved in HRT 3 with some trade-off in specificity compared with MRA of HRT II. 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Design Case-control institutional setting. Methods Seventy-eight glaucoma patients (44 of African ancestry, 34 of European ancestry) and 89 age-matched controls (46 of African ancestry, 33 European ancestry), defined by visual fields and self-reported race were included. Imaging was obtained with HRT II, and data were exported to a computer with the HRT 3 software using the same contour line. Area under the receiver operating characteristic (ROC) curves (AUCs), sensitivity, and specificity were evaluated for the entire group, the African ancestry group, and the European ancestry group separately. Mean disk area was compared between correctly and incorrectly diagnosed eyes by each technique. Results Disk, cup, and rim areas from HRT 3 were lower than HRT II ( P &lt; .0001). AUC (sensitivity at 95% specificity) was 0.85 (54%) for vertical cup-to-disk ratio (VCDR) HRT 3, 0.84 (45%) for VCDR HRT II, and 0.81 (44%) for GPS at the temporal sector. MRA HRT 3 showed greater sensitivity but lower specificity than HRT II for the entire group, the African ancestry group, and the European ancestry group. GPS classification had the lowest specificity. Glaucomatous eyes incorrectly classified by GPS had smaller mean disk area ( P = .0002); control eyes incorrectly classified had greater mean disk area ( P = .015). Conclusions VCDR from HRT 3 showed higher sensitivity than HRT II and GPS for the entire group and for those of African ancestry and of European ancestry separately. Sensitivity of MRA improved in HRT 3 with some trade-off in specificity compared with MRA of HRT II. GPS yielded erroneous classification associated to optic disk size.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17693382</pmid><doi>10.1016/j.ajo.2007.06.021</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Accuracy
African Continental Ancestry Group
Age
Algorithms
Automation
Biological and medical sciences
Classification
Confidence intervals
Cross-Sectional Studies
Data Interpretation, Statistical
Diagnostic Errors
European Continental Ancestry Group
Eyes & eyesight
Female
Genealogy
Glaucoma
Glaucoma and intraocular pressure
Glaucoma, Open-Angle - diagnosis
Glaucoma, Open-Angle - ethnology
Humans
Intraocular Pressure
Lasers
Male
Medical sciences
Middle Aged
Miscellaneous
Ophthalmology
Ophthalmoscopes
Ophthalmoscopy
Optic Disk - pathology
Optic Nerve Diseases - diagnosis
Optic Nerve Diseases - ethnology
Reproducibility of Results
Retina
Sensitivity and Specificity
Software
Standard deviation
Studies
Tomography - methods
Vision Disorders - diagnosis
Visual Field Tests
Visual Fields
title Comparison of Diagnostic Accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to Discriminate Glaucomatous and Nonglaucomatous Eyes
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