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Spotlight on the Disc-Damage Likelihood Scale (DDLS).

Kelvin K W Cheng¹, Andrew J Tatham¹

¹Princess Alexandra Eye Pavilion, Edinburgh, UK.

Clinical Ophthalmology (Auckland, N.Z.)

|October 22, 2021

Summary

This summary is machine-generated.

The Disc Damage Likelihood Scale (DDLS) reliably classifies optic disc damage in glaucoma, offering better reproducibility than the cup-to-disc ratio (CDR). This review confirms its value in clinical practice for diagnosing and monitoring glaucoma.

Keywords:

cup-to-disc ratio disc damage likelihood scale glaucoma rim-to-disc ratio

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Area of Science:

Ophthalmology
Glaucoma Research
Optic Nerve Imaging

Background:

Glaucomatous optic neuropathy requires accurate assessment of optic disc structural changes.
The Disc Damage Likelihood Scale (DDLS) classifies optic disc damage considering neuroretinal rim width and disc size.
The cup-to-disc ratio (CDR) is a common metric, but it does not account for disc size.

Purpose of the Study:

To critically appraise the evidence supporting the Disc Damage Likelihood Scale (DDLS).
To evaluate the role and clinical utility of the DDLS in current glaucoma diagnosis and monitoring practices.
To compare the DDLS with other glaucoma assessment methods, including the cup-to-disc ratio (CDR).

Main Methods:

A systematic literature search identified 33 relevant articles.
Studies were evaluated for reproducibility, diagnostic performance, progression detection, and correlation with other glaucoma markers.
Two independent authors conducted the literature search and appraisal.

Main Results:

The DDLS demonstrated higher reproducibility compared to the cup-to-disc ratio (CDR).
Evidence supports the DDLS as a reliable method for semi-quantitative clinical grading of optic disc changes in glaucoma.
Eleven studies examined the correlation between DDLS and other glaucoma indicators.

Conclusions:

The Disc Damage Likelihood Scale (DDLS) is a valuable and reproducible tool for assessing optic disc structure in glaucoma.
Despite advancements in imaging like OCT, clinical examination using the DDLS remains crucial for glaucoma management.
The DDLS provides a more comprehensive assessment than CDR by incorporating disc size.