title: Comparison of diagnostic accuracy of the RTVue Fourier-domain OCT and the GDx-VCC/ECC polarimeter to detect glaucoma.
abstract: OBJECTIVE
  To compare sensitivity and specificity of retinal nerve fiber layer thickness (RNFLT) measurements made using RTVue-100 Fourier-domain optical coherence tomography (RTVue-OCT) and scanning laser polarimetry with variable (GDx-VCC) or enhanced compensation (GDx-ECC).
  
  
  METHODS
  One eye of each of 177 consecutive patients was imaged. Healthy (n=50) and ocular hypertensive (n = 28) eyes were defined as structurally undamaged, preperimetric (n=33) and perimetric (n=66) glaucoma eyes as diseased.
  
  
  RESULTS
  For average RNFLT, sensitivity was higher (χ(2) test, p=0.002) with RTVue-OCT (65.7%) than with GDx-VCC (49.5%). For superior and inferior RNFLT, sensitivity was similar with all methods. For the different nerve fiber bundle parameters, sensitivity of RTVue-OCT (64.6% to 84.8%) was consistently up to 35% higher (p<0.001) than that of GDx-VCC/ECC (28.3% to 72.7%). Specificity ranged from 84.6% to 98.7% with RTVue-OCT, 92.3% to 100% with GDx-VCC, and 94.9% to 100% with GDx-ECC, with no significant difference between the methods except for one nerve fiber bundle parameter, for which RTVue-OCT was less specific than either GDx method (p ≤ 0.004). Diagnostic accuracy of the GDx-VCC/ECC nerve fiber indicator (NFI) and RTVue-OCT average RNFLT were similar. Of the detected glaucoma cases, 87.7% were identified both by GDx-VCC/ECC NFI and average RNFLT of RTVue-OCT.
  
  
  CONCLUSIONS
  In this clinical setting, all methods were similarly highly specific, but for localized RNFLT damage RTVue-OCT was statistically and clinically significantly more sensitive than GDx-VCC and GDx-ECC. Most detected glaucoma cases were identified with all 3 methods.
authors.affiliation: Department of Ophthalmology, Semmelweis University, Budapest, Hungary. quaranta@med.unibs.it
authors.forename: Anita
authors.initials: A
authors.lastname: Garas
authors.forename: Péter
authors.initials: P
authors.lastname: Vargha
authors.forename: Gábor
authors.initials: G
authors.lastname: Holló
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D005583:Fourier Analysis; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000503:physiopathology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D057109:Scanning Laser Polarimetry / Q000379:methods*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D055815:Young Adult