title: Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma.
abstract: OBJECTIVE
  To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT).
  
  
  METHODS
  The study included 330 experienced participants in five age-related groups: 77 'preperimetric' open-angle glaucoma (OAG) patients, 52 'early' OAG, 50 'moderate' OAG, 54 ocular hypertensive patients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an 'FDT-score', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%.
  
  
  RESULTS
  Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG.
  
  
  CONCLUSIONS
  Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone.
authors.affiliation: Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany. folkert.horn@uk-erlangen.de
authors.forename: F K
authors.initials: FK
authors.lastname: Horn
authors.forename: C Y
authors.initials: CY
authors.lastname: Mardin
authors.forename: D
authors.initials: D
authors.lastname: Bendschneider
authors.forename: A G
authors.initials: AG
authors.lastname: Jünemann
authors.forename: W
authors.initials: W
authors.lastname: Adler
authors.forename: R P
authors.initials: RP
authors.lastname: Tornow
mesh_terms: D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D012372:ROC Curve; D012160:Retina / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*