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KMID : 1813520190080010010
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Journal of the Korean Glaucoma Society
2019 Volume.8 No. 1 p.10 ~ p.20
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Optic Disc-guided Optical Coherence Tomography Interpretation for Diagnosis of Early-glaucoma: Selecting the Optimal Parameters
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Lee Won-June
Oh So-Hee
Kim Ko-Eun
Suh Min-Hee
Kim Martha
Park Ki-Ho
Kim Seok-Hwan
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Abstract
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Purpose : To find adequate models for early-glaucoma diagnosis selecting spectral-domain optical coherence tomography (SD-OCT) parameters based on optic disc evaluation.
Methods : Reliability and validity analysis. Five diagnostic models selecting SD-OCT parameters based on their stereo disc photography (SDP) gradings were proposed (if the SDP was suspected to be normal, the specific SD-OCT parameter was chosen; if the SDP was suspected to be glaucoma, the sensitive parameter was chosen; if the SDP was definitely normal or glaucomatous, the SD-OCT result was not considered). Then, each model was tested for diagnostic accuracy, and the best balanced model was chosen. This model was validated by 3 glaucoma specialists (GSs) and 3 general ophthalmologists (GOs) who tested its diagnostic efficacy. The collective sensitivity and specificity of the GSs and GOs using the selected models were compared with those of the conventional SD-OCT parameters.
Results : A total 111 normal healthy eyes and 107 early-glaucoma eyes were included. All of the diagnostic models showed significantly higher sensitivities than that of the 4-quadrant map (93.5 to 97.2% vs. 86.9%, p = 0.001 to 0.035) and sensitivities similar to that of the 2-dimensional (2D) deviation map. All of the models showed significantly higher specificities than that of the 2D deviation map (82.9 to 95.5% vs. 65.8%, p < 0.001). Model 3 (if SDP was “probably normal” or “unsure,” the 4-quadrant parameter was chosen; if SDP was “probably glaucomatous,” the 2D deviation parameter was chosen; if SDP was definitely normal or glaucomatous, the SD-OCT result was not considered) showed sensitivity similar to that of the 2D deviation map and specificity similar to that of global thickness in both the GS and GO groups.
Conclusions : By combining optic disc evaluation and SD-OCT parameters, the early-glaucoma-diagnostic accuracy of both GSs and GOs can be increased.
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KEYWORD
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Optical coherence tomography, Early glaucoma, Optic disc-guided OCT interpretation
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