Comparison of stereo disc photographs and alternation flicker using a novel matching technology for detecting glaucoma progression.
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.
Radcliffe
Nathan M
NM
Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA. nmr9003@med.cornell.edu
Sehi
Mitra
M
Wallace
Ira B
IB
Greenfield
David S
DS
Krupin
Theodore
T
Ritch
Robert
R
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