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Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma.

Publication ,  Journal Article
Medeiros, FA; Zangwill, LM; Bowd, C; Sample, PA; Weinreb, RN
Published in: Am J Ophthalmol
June 2005

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 > or =80%) as well as for the discrimination between preperimetric GON and normal eyes (AUC = 0.89; sensitivity = 83% for specificity > or =80%). CONCLUSION: SLP differentiated patients with documented progressive optic disk change from normal subjects 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.

Duke Scholars

Published In

Am J Ophthalmol

DOI

ISSN

0002-9394

Publication Date

June 2005

Volume

139

Issue

6

Start / End Page

1010 / 1018

Location

United States

Related Subject Headings

  • Visual Fields
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Standards
  • ROC Curve
  • Prospective Studies
  • Photography
  • Optic Nerve Diseases
  • Optic Disk
  • Ophthalmology & Optometry
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Medeiros, F. A., Zangwill, L. M., Bowd, C., Sample, P. A., & Weinreb, R. N. (2005). Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma. Am J Ophthalmol, 139(6), 1010–1018. https://doi.org/10.1016/j.ajo.2005.01.003
Medeiros, Felipe A., Linda M. Zangwill, Christopher Bowd, Pamela A. Sample, and Robert N. Weinreb. “Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma.Am J Ophthalmol 139, no. 6 (June 2005): 1010–18. https://doi.org/10.1016/j.ajo.2005.01.003.
Medeiros FA, Zangwill LM, Bowd C, Sample PA, Weinreb RN. Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma. Am J Ophthalmol. 2005 Jun;139(6):1010–8.
Medeiros, Felipe A., et al. “Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma.Am J Ophthalmol, vol. 139, no. 6, June 2005, pp. 1010–18. Pubmed, doi:10.1016/j.ajo.2005.01.003.
Medeiros FA, Zangwill LM, Bowd C, Sample PA, Weinreb RN. Use of progressive glaucomatous optic disk change as the reference standard for evaluation of diagnostic tests in glaucoma. Am J Ophthalmol. 2005 Jun;139(6):1010–1018.
Journal cover image

Published In

Am J Ophthalmol

DOI

ISSN

0002-9394

Publication Date

June 2005

Volume

139

Issue

6

Start / End Page

1010 / 1018

Location

United States

Related Subject Headings

  • Visual Fields
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Standards
  • ROC Curve
  • Prospective Studies
  • Photography
  • Optic Nerve Diseases
  • Optic Disk
  • Ophthalmology & Optometry