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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
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Diagnostic performance of modern imaging instruments in glaucoma screening
Elina Karvonen1,2, Katri Stoor3,2, Marja Luodonpää3,2
1Department of Ophthalmology, Oulu University Hospital, Oulu, Finland elina.karvonen@fimnet.fi.
The British Journal of Ophthalmology
|January 18, 2020
Summary
Spectral-domain optical coherence tomography (SD-OCT), scanning laser polarimetry (GDx), and scanning laser ophthalmoscopy (HRT) showed moderate accuracy for glaucoma screening in middle-aged adults. These imaging devices alone are not reliable for screening this population.
Area of Science:
- Ophthalmology
- Medical Imaging
- Public Health
Background:
- Glaucoma screening in middle-aged populations is crucial for early detection and prevention of vision loss.
- Modern imaging devices offer potential for objective glaucoma assessment.
- Evaluating the efficacy of these technologies in unselected populations is essential.
Purpose of the Study:
- To assess the applicability of spectral-domain optical coherence tomography (SD-OCT), scanning laser polarimetry (GDx), and scanning laser ophthalmoscopy (HRT) for glaucoma screening.
- To determine the diagnostic performance of these imaging modalities in a middle-aged, unselected population.
Main Methods:
- A population-based study (Northern Finland Birth Cohort Eye Study) included participants aged 45-49 years.
- Comprehensive eye examinations included SD-OCT (retinal nerve fibre layer and ganglion cell layer analysis), GDx, and HRT.
- Automated classification performance was evaluated against a clinical glaucoma diagnosis (2 out of 3 rule).
Main Results:
- Glaucomatous damage was identified in 1.1% of subjects (43 eyes).
- Sensitivities ranged from 31% (HRT) to 61% (OCT combination), with specificities from 88% (GDx) to 96% (HRT).
- Area under the curve values were moderate (0.73-0.76), and post-test probabilities of glaucoma after a positive finding were low (5-11%).
Conclusions:
- The screening capabilities of OCT, GDx, and HRT were comparable but only moderate in accuracy.
- These imaging parameters, when used alone, are not sufficiently reliable for glaucoma screening in an unselected middle-aged population.
- Further research may be needed to improve the diagnostic performance of these tools for population-based screening.
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