Optic Nerve Head Analysis Obtained by Computerized Stereoscopic Optic Disc Photography

PURPOSE: To compare computerized stereoscopic optic disc photography, plane optic disc photography, and OCT in ONH analysis and predictability of glaucomatous field defects. METHODS: A total of 99 eyes of 50 patients were studied from December 2004 to February 2005. Complete ophthalmic examinations were performed which included computerized stereoscopic optic disc photography, plane optic disc photography, OCT, and a visual field test. RESULTS: The three methods analyzed in this study were largely correlated with each other. However, the horizontal cup-disc ratio using OCT differed from the other methods. The most valuable data was vertical CDR estimation using computerized stereoscopic optic disc photography. The sensitivity and specificity of computerized stereoscopic optic disc photography on a glaucomatous field defect using multivariate analysis were 80% and 100%, respectively. The hit ratios of computerized stereoscopic optic disc photography, plane optic disc photography, and OCT were 90.9, 81.6 and 60.7, respectively. CONCLUSIONS: ONH analysis using computerized stereoscopic optic disc photography may be a benefit in the diagnosis and follow-up of glaucoma patients. It is thought that easy accessibility and convenient storage of computerized photography will be useful for the detection of glaucomatous visual field defects.

Comparison of Diagnostic Precision between Preprogramed Indicator and Newly Calculated Indicator in Optical Coherence Tomography

PURPOSE: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis using optical coherence tomography (OCT) and to compare the diagnostic precision between the new discriminant formula and the preprogrammed indicator (95%, 99% cut off value of normal RNFL thickness) in the diagnosis of glaucoma. METHODS: The study comprised 499 eyes of 284 patients. Routine ophthalmic examinations, fundus examination, visual field test, OCT optic nerve head analysis and OCT RNFL analysis were performed. Results were analyzed and classified into normal, suspected glaucoma, and glaucoma groups. RESULTS: There were 237 glaucomatous eyes and all parameters of the OCT RNFL analysis showed statistically significant differences between the glaucoma and non-glaucoma groups. The average RNFL thickness was most significantly correlated with the visual field indexes and was the most useful parameter in the detection of glaucoma. Using age, horizontal integrated rim area (HIRA) and average thickness, the accuracy, sensitivity and specificity of the new discriminant formula were 76.2%, 73.1% and 73.1% respectively. CONCLUSIONS: Average thickness was the most useful parameter in the detection of glaucoma. The next most useful parameter was inferior average thickness, and both were more precise than the preprogrammed indicator. The new discriminant formula is useful in the diagnosis and follow-up of the glaucoma patients.

Optic Nerve Head Analysis Obtained by Optical Coherence Tomography for the Diagnosis of Glaucoma in Koreans

PURPOSE: To find the optimal parameter of the optic nerve head (ONH) analysis using Optical Coherence Tomography (OCT) and to form a diagnostic classification for the detection of glaucoma in Koreans. METHODS: The subjects of this study were 799 eyes of 400 patients at Kangnam St. Mary's Hospital from June 2003 to March 2004. Complete ophthalmic examinations containing the visual field test and OCT ONH analysis (StratusOCT, software ver. 3.0, Carl Zeiss Meditec, Inc, Dublin, CA, USA) were performed and the results were analyzed in the normal, glaucoma suspect and glaucoma groups. RESULTS: In the 799 eyes, there were 378 glaucomatous eyes. There was a statistically significant difference between glaucoma and non-glaucoma patients in all parameters of OCT ONH analysis except for the disc area. The horizontal integrated rim area (HIRA) was most significantly correlated with the visual field indices (MD and CPSD) and was the most useful parameter in glaucoma detection. Based on age and HIRA, the new discriminant formula = -1.858 - 0.028 x Age + 2.518 x HIRA was obtained and its accuracy, sensitivity and specificity were 72.8%, 71.5% and 73.8% respectively. CONCLUSIONS: HIRA was the most useful parameter in the detection of glaucoma. The new discriminant formula from OCT ONH analysis is expected to be useful in the diagnosis and follow-up of glaucoma in Koreans.