title: Comparison of stereo disc photographs and alternation flicker using a novel matching technology for detecting glaucoma progression.
abstract: OBJECTIVE
  To compare agreement of automated alternation flicker and serial stereophotograph inspection for detection of progressive glaucoma.
  
  
  METHODS
  Serial photographs of patients with glaucoma with at least 36 months of follow-up and perimetry every 4 months were assessed by four graders using predefined criteria with both flicker and stereophotography. The main outcome measure was progressive neuroretinal rim deterioration as identified by each technique.
  
  
  RESULTS
  Forty eyes (20 patients) were included and 12 eyes progressed with perimetry. Using stereophotography, the overall agreement (kappa ± standard error) was 0.19 ± 0.06 for rim change, 0.78 ± 0.06 for disc hemorrhage, and -0.04 ± 0.06 for vessel movement. Using flicker, the overall agreement was similar for rim change (0.28 ± 0.06; P = .29), worse for disc hemorrhage (0.43 ± 0.06; P < .001), and better for vessel movement (0.22 ± 0.06; P = .002). The agreement between perimetric and disc progression was similar using stereophotography (0.10 ± 0.05) and flicker (0.19 ± 0.05; P = .20).
  
  
  CONCLUSIONS
  Agreement between flicker and stereophotography was similar.
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA. nmr9003@med.cornell.edu
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Radcliffe
authors.forename: Mitra
authors.initials: M
authors.lastname: Sehi
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wallace
authors.forename: David S
authors.initials: DS
authors.lastname: Greenfield
authors.forename: Theodore
authors.initials: T
authors.lastname: Krupin
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
mesh_terms: D000465:Algorithms; D001331:Automation; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005901:Glaucoma / Q000175:diagnosis*; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D016014:Linear Models; D009898:Optic Disk / Q000098:blood supply; D010780:Photogrammetry; D012160:Retina / Q000473:pathology; D058609:Visual Field Tests