Comparison of the Results between Heidelberg Retina Tomography II and Stratus Optical Coherence Tomography in Glaucoma

PURPOSE: To evaluate the ability of Stratus OCT and HRT II with Moorfields' analysis to detect localized RNFL defects and to evaluate the accordance of Stratus OCT and HRT II results in glaucoma patients. METHODS: A total of 60 patients (119 eyes) who had localized RNFL defects of either eye in red-free fundus photographs unserwent evaluation by Stratus OCT and HRT II. For the results of Stratus OCT and HRT II with Moorfields' analysis, normal distribution percentiles less than 5% were considered a significant RNFL defect. For each disc, superotemporal and inferotemporal portions were evaluated. The diagnostic abilities of Stratus OCT and HRT II to detect localized RNFL defects were calculated. The results of HRT II were compared with those of Stratus OCT. RESULTS: The overall sensitivity, specificity, positive predictive value and negative predictive value to detect localized RNFL defects were 67.9%, 88.9%, 84.3% and 76.5% in Stratus OCT and 67.3%, 64.8%, 62.2% and 69.6% in HRT II, respectively. Compared with Stratus OCT, 67.2% of HRT II results were in accord in the superotemporal portion and 68.9% in the inferotemporal portion. The accordance of detection of RNFL defects between the two instruments in the inferotemoral portion was higher (79.2%) than others. CONCLUSIONS: Stratus OCT with a normative database is a useful aid to detect localized RNFL defects in early glaucoma. If observation of topographic changes of the optic disc with HRT II is added, results will be even better.

The correlation between the structural parameters provided by the Heidelberg retina tomography (HRT) and laser diagnostics glaucoma scanning system (GDx) in primary open angle glaucoma / 眼科

Objective To investigate the correlation between the structural parameters provided by the Heidelberg retina tomogra- phy (HRT) and the structural parameters provided by laser diagnostics glaucoma scanning system (GDx), to discuss whether the correla- tion between them be used to make a more accurate diagnosis. Design Case control study. Participants Thirty-two patients (49 eyes) with primary open angle glaucoma and 15 patients only with abnormal GDx results. Methods The patients underwent examination with HRT, GDx. The relations between the topographic parameters of GDx Ecc and HRT were analysed by linear regression. F test was used to analyse whether there was a spatial correspondence between the GDx Ecc and HRT I]. Maim Outcome Measures The topographic parameters generated by GDx Ecc and HRTⅡ. Results In glaucoma group, among the topographic parameters generated by GDx Ecc and HRTⅡ. The correlation between NFI and rim area was significant (r=-0.68,P=-0.000). The spatial correspondence between GDx Ecc and HRTⅡwas also significant. In control group, NFI and rim area also had the significant correlation among the parameters of optic nerve head and retinal nerve fiber layer (r=-0.79, P=0.001). But there was no spatial correspondence between the GDx Ecc and HRTⅡ. Conclusions There is a spatial correspondence between GDx and HRT, but this correspondence doesn't existence in patients only with abnormal GDx result. This difference can be used to make a more accurate diagnosis.

Glaucoma Discrimination by Combined Use of Frequency Doubling Technology and Heidelberg Retina Tomography II

PURPOSE: This study investigated whether the combined use of Frequency Doubling Technology and Heidelberg Retina Tomography II increases the usefulness of glaucoma detection. METHODS: The study subjects were, 59 patients with POAG and 34 normal persons were selected. The authors defined a total of six discriminative criteria: F1, in which the conventional analysis of FDT was used; F2, in which the FDT scoring system was used; F3, in which the Moorfield classification of HRT was used; F4, in which the new HRT discrimination function `Z' was used; F5, in which F1 and F3 were combined, and F6, in which F2 and F4 were combined; The usefulness of each criterion was investigated. RESULTS: The sensitivity, specificity, and area under the ROC curve of the six discriminative criteria were: 86.4%, 58.8%, and 0.740 in F1, 4.5%, 80.0% (cutoff: 12.50), and 0.882 in F2, 79.7%, 61.8%, and 0.679 in F3, 77.6%, 74.3% (cutoff: 0), and 0.857 in F4, 77.6%, 71.4% (cutoff: 1.0805), and 0.767 in F5, and 86.2%, 91.4% (cutoff: 0.495) and 0.931 in F6. CONCLUSIONS: Combined use of functional (FDT) and morphological (HRT) aspects, which are early parameters of glaucoma damage, gave more useful results than a single analysis of each. Thererfore, the combined use will help the early detection of glaucoma.

Evaluation of Macular Hole Surgery using Confocal Laser Tomography

Macular hole can be quantitated by measuring its diameter, depth and volume with Heidelberg retina tomograph(HRT). In this study, effectiveness of macular hole surgery was investigated using HRT. Patients with good preoperative visual acuity showed better visual improvement after surgery. The macular holes of stage 1 and stage 2 had better visual prognosis than those of stage 3 and stage 4. Idiopathic holes had better visual prognosis than traumatic holes. Following surgery, the diameters of the macular holes were significantly decreased in eyes with postoperative visual improvement, and significantly increased in eyes with decrease in visual acuity. The diameter of a macular hole is a good indicator for the correlation of vision in macular hole surgery. Initial visual acuity and stage of macular holes were the most significant prognostic factors.

Study of comparison of optic nerve between big cupped disc and early glaucoma / 眼科

Objective To investigate the sensitivity of Heidelberg Retina Tomography (HRT-Ⅱ)parameters on the early optic nerve change of glaucoma head. Design Cross-sectional study. Participants Twenty-one patients (36 eyes) with big cupped disc(C/ D≥0.7) and twenty-seven patients (31 eyes) with early glaucoma (C/D≥0.7, MD≤3dB) were studied. Methods All patients underwent visual field and HRT-Ⅱ examination to get parameters of optic nerve head. T test was used to compare the parameters of optic disc between big cupped disc and early glaucoma. Main Outcome Measures HRT Ⅱ parameters included disc area, cup area, rim area, cup volume, rim volume, C/D area ratio, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean RNFL thickness and RNFL cross sectional area. Results Statistics analysis with T test (t=2.247-3.714, P=0.000-0.028) showed there were significant differences of rim area, rim volume, mean retinal nerve fiber layer thickness, sectional area of retinal nerve fiber layer between big cupped disc and early glaucoma. Conclusions We can pay attention to those parameters with HRT- Ⅱ to distinguish patients with big cupped disc and early glaucoma.