title: Diagnostic ability of a linear discriminant function for spectral-domain optical coherence tomography in patients with multiple sclerosis.
abstract: OBJECTIVE
  To calculate and validate a linear discriminant function (LDF) for spectral-domain optical coherence tomography (OCT) to improve the diagnostic ability of retinal nerve fiber layer (RNFL) thickness parameters for the detection of multiple sclerosis (MS).
  
  
  METHODS
  Observational cross-sectional study.
  
  
  METHODS
  Patients with multiple sclerosis (n = 115) and age-matched healthy subjects (n = 115) were enrolled in the study.
  
  
  METHODS
  The Spectralis OCT system (Heidelberg Engineering, Heidelberg, Germany) was used to obtain the circumpapillary RNFL thickness in both eyes of each participant.
  
  
  METHODS
  A validating set including 60% of the study subjects (69 healthy individuals and 69 patients with MS) was used to test the performance of the LDF in an independent population. Receiver operating characteristic (ROC) curves were plotted and compared with the RNFL parameters measured using OCT. Sensitivity and specificity were used to evaluate diagnostic performance.
  
  
  RESULTS
  The optimized function was 4.965 - 0.40 × (mean thickness 15-30 degrees) - 0.17 × (mean thickness 300-315 degrees) + 2.743 - 0.032 × (mean thickness 105-120 degrees) - 0.031 × (mean thickness 120-135 degrees) - 0.018 × (mean thickness 225-240 degrees). The largest area under the ROC curve was 0.834 for our LDF in the validating population. At 95% fixed specificity, the LDF yielded the highest sensitivity values.
  
  
  CONCLUSIONS
  Measurements of RNFL thickness obtained with Spectralis OCT had good ability to differentiate between healthy individuals and individuals with MS. On the basis of the area under the ROC curve, the LDF performed better than any single parameter.
authors.affiliation: Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain. egmvivax@yahoo.com
authors.forename: Elena
authors.initials: E
authors.lastname: Garcia-Martin
authors.forename: Luis E
authors.initials: LE
authors.lastname: Pablo
authors.forename: Raquel
authors.initials: R
authors.lastname: Herrero
authors.forename: Maria
authors.initials: M
authors.lastname: Satue
authors.forename: Vicente
authors.initials: V
authors.lastname: Polo
authors.forename: Jose M
authors.initials: JM
authors.lastname: Larrosa
authors.forename: Jesus
authors.initials: J
authors.lastname: Martin
authors.forename: Javier
authors.initials: J
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001369:Axons / Q000473:pathology*; D003430:Cross-Sectional Studies; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy; D000069442:Natalizumab; D009902:Optic Neuritis / Q000175:diagnosis; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab; D016899:Interferon-beta