Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma
Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma
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DOI：
10.1016/j.ajo.2005.01.003
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发表时间：
2005-06-01
影响因子：
4.2
通讯作者：
Weinreb, RN
中科院分区：
文献类型：
--
作者：
Medeiros, FA;Zangwill, LM;Weinreb, RN
目的：视盘外观的进行性改变已被认为是青光眼诊断的最佳参考标准。我们评估的准确性，扫描激光偏振仪（SLP）与可变角膜补偿歧视患者记录进行性视盘变化从健康subjects.DESIGN：观察病例对照study.METHODS：青光眼患者记录的证据进行性视盘变化评估立体照片被选中。健康对照受试者视野正常，临床检查正常。所有受试者均使用GDx VCC扫描激光偏振仪进行成像。受试者工作特征（ROC）曲线，在固定的特异性，和似然比进行了calculated.RESULTS：65眼健康对照患者。进行性视盘改变71眼，其中视野检查异常者41眼（58%），视野检查前视野正常者30眼（42%）。GDx VCC参数神经纤维指示器在区分周边GON和正常眼方面表现最好（AUC = 0.94;特异性>= 80%的灵敏度= 93%）以及用于区分视野前GON和正常眼（AUC = 0.89;灵敏度= 83%，特异性>= 80%）。SLP将有记录的进行性视盘改变的患者与正常视盘下病变和确诊为视野前GON的患者中检测到的异常区分开来，提示其可能对青光眼的早期诊断有用。我们认为，在评价青光眼影像学诊断的准确性时，应采用进行性视盘改变。(c)2005年，Elsevier Inc. All rights reserved.
PURPOSE: Progressive change in optic disk appearance has been suggested as the best available reference standard for glaucoma diagnosis. We evaluated the accuracy of scanning laser polarimetry (SLP) with variable corneal compensation to discriminate patients with documented progressive optic disk change from healthy subjects.DESIGN: Observational case-control study.METHODS: Glaucoma patients with documented evidence of progressive optic disk change as assessed by stereoscopic photographs were selected. Healthy control subjects had normal visual fields and normal clinical examination. All subjects underwent imaging with the GDx VCC scanning laser polarimeter. Receiver-operating characteristic (ROC) curves, sensitivities at fixed specificities, and likelihood ratios were calculated.RESULTS: Sixty-five eyes were healthy control patients. Seventy,one eyes had progressive optic disk change, of which 41 (58%) had abnormal visual field tests closest to the imaging date (perimetric glaucomatous optic neuropathy [GON]), and 30 (42%) eyes had normal visual fields (preperimetric GON). The GDx VCC parameter nerve fiber indicator performed best for discrimination between perimetric GON and normal eyes (AUC = 0.94; sensitivity = 93% for specificity >= 80%) as well as for the discrimination between preperimetric GON and normal eyes (AUC = 0.89; sensitivity = 83% for specificity >= 80%).CONCLUSION: SLP differentiated patients with documented progressive optic disk change from normal sub, jects and detected abnormalities in patients with confirmed diagnosis of preperimetric GON, suggesting that it may be useful for early glaucoma diagnosis. We suggest that progressive optic disk change should be used in the evaluation of diagnostic accuracy of imaging instruments for glaucoma. (c) 2005 by Elsevier Inc. All rights reserved.