Optic disc damage staging system.
OBJECTIVE
To evaluate the optic disc damage staging system (ODDSS); a new clinical method of optic disc (OD) classification based on OD size, neural rim (NR) loss severity and localization. Accuracy, reproducibility, and reliability were studied. Agreement of ODDSS with the Heidelberg-Retina-Tomograph (HRT) results was evaluated.


METHODS
One eye of 68 consecutive open-angle glaucoma (POAG) patients and 40 controls underwent standard automated perimetry (SAP), HRT-II, and OD examination using the ODDSS classification by 3 independent graders in this prospective cross-sectional study. Sensitivity, specificity, and area under the receiver operating characteristic curve (AROC) in discriminating between normal and POAG eyes were determined for ODDSS and HRT parameters. ODDSS intraobserver and interobserver agreement and agreement with HRT-Moorfield-Regression-Analysis (MRA) were assessed.


RESULTS
ODDSS sensitivity ranged from 72.0% to 89.7%; specificity ranged from 92.5% to 100%. Differences between AROCs for ODDSS (0.89 to 0.94) and for the best-performing HRT parameter (Vertical Cup/Disc Ratio 0.88) were not statistically significant. ODDSS interobserver agreement ranged from 0.33 to 0.78; intraobserver agreement ranged from 0.53 to 0.89. Agreement with HRT-MRA ranged from 0.50 to 0.87.


CONCLUSIONS
ODDSS is a new method for assessing, recording, and sharing information about the clinical OD appearance. Our preliminary results show that it provides good sensitivity and specificity in glaucoma detection. The interobserver and intraobserver agreement ranged from fair to good.
Brusini
Paolo
P
Department of Ophthalmology, Azienda Ospedaliero-Universitaria Santa Maria Della Misericordia, Udine, Italy. brusini@libero.it
Zeppieri
Marco
M
Tosoni
Claudia
C
Parisi
Lucia
L
Salvetat
Maria Letizia
ML
D000368:Aged; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000145:classification* / Q000175:diagnosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D058609:Visual Field Tests; D014794:Visual Fields