title: Performance of imaging devices versus optic disc and fiber layer photography in a clinical practice guideline for glaucoma diagnosis.
abstract: OBJECTIVE
  To compare the performance of Moorfields Regression Analysis (MRA) and optical coherence tomography (OCT) with that of photographic evaluation of the optic nerve head and retinal nerve fiber layer (RNFL) in the application of the Finnish Evidence-Based Guideline for Open-Angle Glaucoma (FEBG-OAG).
  
  
  METHODS
  Patients referred for glaucoma evaluation (n=312) and subjects selected from the general population (n=41) were included in the study. All subjects underwent ophthalmic evaluation, optic nerve head stereophotography, monochromatic RNFL photography, Heidelberg retina tomography, OCT, and laser polarimetry evaluation. The subjects were classified based on stereophotographic or MRA and OCT results by applying the FEBG-OAG.
  
  
  RESULTS
  The specificity of the FEBG-OAG for detecting normal patients (stereophotography and imaging devices) was 78% (strict criteria) and 100% (liberal criteria). Agreement between the stereophotographic evaluation and evaluation based on MRA and OCT was 70.2%. Classification of subjects with similar management advice based on these evaluations had 70.5% agreement. Central corneal thickness was a confounding factor in glaucoma diagnosis. Large optic disc sizes played a major role in misleading the diagnosis compared to small discs.
  
  
  CONCLUSIONS
  Central corneal thickness and large optic disc size are confounding factors in glaucoma diagnosis. Moorfields Regression Analysis and OCT allow for objective implementation of the FEBG-OAG compared to conventional stereophotographic evaluation of the neuroretinal structures.
authors.affiliation: Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain. noemiguerri@hotmail.com
authors.forename: Noemi
authors.initials: N
authors.lastname: Güerri
authors.forename: Vicente
authors.initials: V
authors.lastname: Polo
authors.forename: Jose M
authors.initials: JM
authors.lastname: Larrosa
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferreras
authors.forename: Isabel
authors.initials: I
authors.lastname: Fuertes
authors.forename: Luis E
authors.initials: LE
authors.lastname: Pablo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000592:standards*; D005902:Glaucoma, Open-Angle / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000145:classification / Q000175:diagnosis*; D010781:Photography; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012044:Regression Analysis; D012165:Retinal Ganglion Cells / Q000473:pathology*; D057109:Scanning Laser Polarimetry; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests