Sensitivity and Specificity With the Glaucoma Probability Score in Heidelberg Retina Tomograph II in Japanese Eyes

PurposeTo evaluate the sensitivity and specificity with glaucoma probability score (GPS), a new glaucoma diagnosis program in Heidelberg Retina Tomograph II ver 3.0 in detecting early glaucoma in Japanese eyes. Patients and MethodsSensitivity and specificity with GPS were determined in 148 early stage open-angle glaucoma eyes of 148 hospital-based patients (mean deviation >−5 dB) and age-matched and refraction-matched 148 eyes of 148 ophthalmologically normal subjects selected from a population-based sample of the Tajimi Study. The results with GPS were compared with those with Moorfields regression analysis (MRA) and FS Mikelberg discriminant function (FSM). Analysis was also carried out by stratifying the eyes by refraction and disc area. ResultsFor all glaucoma eyes, sensitivity with GPS (71.7%) was similar to MRA and FSM (75.2%, P=0.8; 77.2%, P=0.5; Fisher exact test). Specificity with GPS (80.7%) was also statistically equivalent with MRA and FSM (91.1%, P=0.06; 87.4%, P=0.3). Although sensitivity with GPS was lower in higher myopic eyes than in the less myopic eyes, specificity did not differ with refractive error. Specificity with GPS was lower and sensitivity higher (P<0.0001) in larger discs (>2.0 mm2) than in smaller discs (≤2 mm2). In larger discs, specificity with GPS was lower (P=0.005) than with MRA and in smaller discs, sensitivity with GPS was lower than with MRA or FSM. ConclusionsIn Japanese eyes, sensitivity and specificity with GPS to detect early glaucoma were similar with MRA or FSM, although the specificity tended to be lower than results in white eyes. Subgroup analysis revealed a notable dependency in diagnostic ability on disc area and refractive error. The diagnostic ability of GPS is still not sufficient for glaucoma detection in the Japanese population requiring further investigation.

[1]  J. M. Miller,et al.  Optic disc rim area is related to disc size in normal subjects. , 1987, Archives of ophthalmology.

[2]  J. Jonas,et al.  Optic disc, cup and neuroretinal rim size, configuration and correlations in normal eyes. , 1988, Investigative ophthalmology & visual science.

[3]  R. Ritch,et al.  Racial differences in optic nerve head parameters. , 1989, Archives of ophthalmology.

[4]  Douglas R. Anderson Automated Static Perimetry , 1992 .

[5]  A. Sommer,et al.  Race-, age-, gender-, and refractive error-related differences in the normal optic disc. , 1994, Archives of ophthalmology.

[6]  N. Swindale,et al.  Ability of the Heidelberg Retina Tomograph to Detect Early Glaucomatous Visual Field Loss , 1995, Journal of glaucoma.

[7]  J. Caprioli,et al.  Detection of structural damage from glaucoma with confocal laser image analysis. , 1996, Investigative ophthalmology & visual science.

[8]  S. Drance,et al.  The effect of optic disc size on diagnostic precision with the Heidelberg retina tomograph. , 1997, Ophthalmology (Rochester, Minn.).

[9]  G. Wollstein,et al.  Identification of early glaucoma cases with the scanning laser ophthalmoscope. , 1998, Ophthalmology.

[10]  G. Wollstein,et al.  Inter- and intraobserver variation in the analysis of optic disc images: comparison of the Heidelberg retina tomograph and computer assisted planimetry , 1999, The British journal of ophthalmology.

[11]  A. Hofman,et al.  Determinants of optic disc characteristics in a general population: The Rotterdam Study. , 1999, Ophthalmology.

[12]  N. Swindale,et al.  Automated analysis of normal and glaucomatous optic nerve head topography images. , 2000, Investigative ophthalmology & visual science.

[13]  T. Wong,et al.  Prevalence and risk factors for refractive errors in adult Chinese in Singapore. , 2000, Investigative ophthalmology & visual science.

[14]  J. Jonas,et al.  Interobserver variability of optic disk variables measured by confocal scanning laser tomography. , 2001, American journal of ophthalmology.

[15]  Ching-Yu Cheng,et al.  Refractive errors in an elderly Chinese population in Taiwan: the Shihpai Eye Study. , 2003, Investigative ophthalmology & visual science.

[16]  M. Nicolela,et al.  Comparison of data analysis tools for detection of glaucoma with the Heidelberg Retina Tomograph. , 2003, Ophthalmology.

[17]  N. Shimizu,et al.  Refractive errors and factors associated with myopia in an adult Japanese population. , 2003, Japanese journal of ophthalmology.

[18]  T. Sejnowski,et al.  Heidelberg retina tomograph measurements of the optic disc and parapapillary retina for detecting glaucoma analyzed by machine learning classifiers. , 2004, Investigative ophthalmology & visual science.

[19]  A. Iwase,et al.  The prevalence of primary open-angle glaucoma in Japanese: the Tajimi Study. , 2004, Ophthalmology.

[20]  M. Kass,et al.  Racial differences in optic disc topography: baseline results from the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study. , 2004, Archives of ophthalmology.

[21]  F. Medeiros,et al.  Differences in visual function and optic nerve structure between healthy eyes of blacks and whites. , 2005, Archives of ophthalmology.

[22]  M. Araie,et al.  Topographic Characteristics of the Optic Nerve Head Measured with Scanning Laser Tomography in Normal Japanese Subjects , 2005, Japanese Journal of Ophthalmology.

[23]  C. Girkin,et al.  Differences in optic disc topography between black and white normal subjects. , 2005, Ophthalmology.

[24]  J. Jonas,et al.  Optic disc size in a population based study in northern China: the Beijing Eye Study , 2006, British Journal of Ophthalmology.

[25]  R. Ritch,et al.  Assessment of a Race-specific Normative HRT-III Database to Differentiate Glaucomatous From Normal Eyes , 2006, Journal of glaucoma.

[26]  R. Ritch,et al.  Detection of glaucoma using operator-dependent versus operator-independent classification in the Heidelberg retinal tomograph-III , 2006, British Journal of Ophthalmology.

[27]  F. Medeiros,et al.  Influence of disease severity and optic disc size on the diagnostic performance of imaging instruments in glaucoma. , 2006, Investigative ophthalmology & visual science.

[28]  P. Artes,et al.  Automated analysis of heidelberg retina tomograph optic disc images by glaucoma probability score. , 2006, Investigative ophthalmology & visual science.

[29]  G. Wollstein,et al.  Glaucoma detection with the Heidelberg retina tomograph 3. , 2007, Ophthalmology.

[30]  L. Sakata,et al.  Comparison of diagnostic accuracy of Heidelberg Retina Tomograph II and Heidelberg Retina Tomograph 3 to discriminate glaucomatous and nonglaucomatous eyes. , 2007, American journal of ophthalmology.

[31]  A. Iwase,et al.  Refractive errors in an elderly Japanese population: the Tajimi study. , 2008, Ophthalmology.