ABSTRACT
AIM: To compare the performance of Heidelberg retina tomograph (HRT) and scanning laser polarimetry (GDx) with photographic evaluation of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) in the application of the Finnish Evidence-Based Guideline for Open-Angle Glaucoma. METHODS: A total of 41 control participants and 312 patients referred for glaucoma evaluation were included in the study. All the participants underwent ophthalmic evaluation, ONH stereophotography, monochromatic RNFL photography, HRT, optical coherence tomography, and GDx evaluation. Participants were classified on the basis of stereophotographic or imaging device results based by applying the Finnish Guideline. RESULTS: Agreement between the stereophotographic evaluation and that on the basis of the imaging devices was 52.9%. Classification of patients with similar management advice on the basis of these evaluations had 56.4% agreement. The specificity of the Finnish guideline for detecting normal patients was 78% (stereophotography) and 83% (imaging devices). Optic disc size interfered with the diagnosis in patients evaluated using the HRT3 glaucoma probability score. Structural changes were more frequently detected before functional changes. CONCLUSION: The Finnish Evidence-Based Guideline for Open-Angle Glaucoma is useful for classifying normal participants and patients with suspected glaucoma or glaucoma through either conventional stereophotographic evaluation of the neuroretinal structures or with the new imaging devices.
Subject(s)
Glaucoma, Open-Angle/diagnosis , Practice Guidelines as Topic , Retina/pathology , Scanning Laser Polarimetry , Tomography, Optical/methods , Aged , Evidence-Based Medicine , Female , Finland , Humans , Lasers , Male , Middle Aged , Prospective Studies , Tomography, Optical/standardsABSTRACT
PURPOSE: To compare the central corneal thickness, measured with an ultrasound pachymeter, in normal subjects, those with ocular hypertension, glaucoma suspects and patients with preperimetric glaucoma. METHODS: 61 normal eyes (control group), 131 eyes with ocular hypertension, 62 glaucoma suspects (optic nerve head morphology compatible with glaucoma) and 36 patients with preperimetric glaucoma (abnormal short-wavelength automated perimetry) were prospectively and consecutively selected. Scatter plots of central corneal thickness, against the intraocular pressure values were calculated for each of the study groups. Ultrasound pachymetry measurements were compared between those with normal eyes and the other groups. RESULTS: Ocular hypertensive subjects had higher pachymetry values than the control group (p=0.009). No differences were found in the central corneal thickness between normal eyes and those who were glaucoma suspects, and between normal and preperimetric glaucomatous eyes. A mild direct logarithmic correlation was evident between central corneal thickness and the Goldmann tonometry result in the ocular hypertensive group. CONCLUSIONS: Ocular hypertensive subjects had thicker corneas than the other groups studied. Glaucoma suspects and preperimetric glaucoma patients had similar corneal thickness to the control group.
