Logistic regression analysis for early glaucoma diagnosis using optical coherence tomography.
OBJECTIVE
To determine and validate the diagnostic ability of a linear discriminant function (LDF) based on the retinal nerve fiber layer thickness at each of the 12 clock-hour positions obtained using optical coherence tomography for discriminating between healthy eyes and eyes with early glaucomatous visual field loss.


METHODS
We prospectively selected 62 consecutive healthy individuals and 73 patients with open-angle glaucoma to calculate the LDF. Another independent prospective sample of 280 healthy eyes and 302 glaucomatous eyes was used to evaluate the diagnostic accuracy of the LDF.


RESULTS
The proposed function was LDF = 15.584 - (12-o'clock segment thickness x 0.032) - (7-o'clock segment thickness x 0.041) - (3-o'clock segment thickness [nasal side] x 0.121). The greatest area under the receiver operating characteristic curve was observed for our LDF in both populations: 0.962 and 0.922. Our LDF and the average thickness yielded sensitivities of 74.5% and 67.8%, respectively, at a fixed specificity of 95%.


CONCLUSIONS
The LDF increased the diagnostic ability of the isolated retinal nerve fiber layer thickness at the 12 clock-hour positions. Compared with optical coherence tomography-provided parameters, our LDF had the highest sensitivities at 85% and 95% fixed specificities to discriminate between healthy and early glaucomatous eyes.
Ferreras
Antonio
A
Department of Ophthalmology, Miguel Servet University Hospital, Isabel la Católica 1-3, 50009 Zaragoza, Spain. aferreras@msn.com
Pablo
Luís E
LE
Pajarín
Ana B
AB
Larrosa
José M
JM
Polo
Vicente
V
Honrubia
Francisco M
FM
D019540:Area Under Curve; D016002:Discriminant Analysis; D017889:Exfoliation Syndrome / Q000175:diagnosis; D005188:False Negative Reactions; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D016015:Logistic Models; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis; D058609:Visual Field Tests; D014794:Visual Fields