Correlation between disc damage likelihood scale and optical coherence tomography in the diagnosis of glaucoma.

PURPOSE: To investigate the relationship between the Disc Damage Likelihood Scale (DDLS), visual field and various optical coherence tomography (OCT) parameters for glaucoma diagnosis. METHODS: The study comprised 149 eyes from 149 patients. The patients were categorized as normal, glaucoma suspect or with glaucoma. They were clinically examined and graded according to the DDLS system. OCT was performed to acquire both a retinal nerve fibre layer analysis and an optic nerve head analysis. The relationships between DDLS score, visual field and OCT parameters were analysed using multiple correlation analysis. RESULTS: The normal, glaucoma suspect and glaucoma groups had average DDLS scores of 1.58 +/- 1.40, 2.55 +/- 1.93 and 5.33 +/- 1.39, respectively. Evaluating the area under the receiver operator characteristic curve, the DDLS had the best predictive power (0.917), followed by corrected pattern standard deviation. CONCLUSION: The DDLS is a useful parameter in the diagnosis of glaucoma and it showed a close correlation with visual field, cup/disc ratio and OCT parameters.

A prospective audit on the validity of written informed consent prior to glaucoma surgery: an Asian perspective.

PURPOSE: To assess the validity of written informed consent taken from patients prior to undergoing glaucoma surgery by testing their ability to understand the information offered to them during the consent-taking process. METHODS: Seventy-three patients were asked to complete a standardised confidential questionnaire after giving a written informed consent. Surgeons who were taking the consent were also requested to submit their self-evaluation form. Patients' understanding of the information they were given was evaluated using a standardised point scoring system. RESULTS: Fifty patients (68.5%) agreed that they were given enough time to make an informed decision, while 67 doctors (91.8%) claimed that they had allocated enough time to explain the procedures. Fifty-two patients (71.2%) reported that they were given adequate information on the details or diagnosis of their problems, 65 patients (89.0%) on the details of the procedure and 69 patients (94.5%) on the risks and complications. Thirty-four patients (46.6%) were not sure, or refused information on the risks and complications of the procedure. Only half of the patients (57.5%) had overall moderate understanding of their surgical problem, and only 13 patients (17.8%) were able to demonstrate a good overall understanding of their surgical problem. CONCLUSIONS: Although most patients acknowledged that they received sufficient information to give consent, few could objectively recall the information given to them. This study thus raises some doubts on the validity and quality of written informed consent, and highlights the importance of giving clear information to patients undergoing glaucoma surgery.