title: Measuring hemoglobin levels in the optic nerve head: comparisons with other structural and functional parameters of glaucoma.
abstract: OBJECTIVE
  We evaluated and compared the ability of a new method for measuring hemoglobin (Hb) levels at the optic nerve head (ONH) to that of visual field evaluation, scanning laser ophthalmoscopy (HRT), scanning laser polarimetry (GDx), and optical coherence tomography (OCT) for diagnosing glaucoma.
  
  
  METHODS
  Healthy eyes (n = 102) and glaucomatous eyes (n = 101) underwent reliable Oculus Spark perimetry, and imaging with the HRT, GDx, and Cirrus OCT. In addition, ONH color images were acquired with a non-mydriatic fundus camera. The Laguna ON(h)E program then was used to calculate the Hb amount in each of 24 sectors of the ONH. Sensitivities at 95% fixed specificity, diagnostic agreement, and linear correlations between parameters with the best diagnostic ability were calculated.
  
  
  RESULTS
  The glaucoma discriminant function (GDF) of the Laguna program, evaluating Hb in the vertical intermediate sectors and center/periphery Hb amount slope, yielded an 89.1% sensitivity and 95.1% specificity, which was superior or similar to the other tests. The best GDF diagnostic agreement was for the OCT-vertical cup-to-disc (C/D) ratio (kappa = 0.772) and the final phase Spark pattern SD (kappa = 0.672). Hb levels correlated strongly with the Spark mean sensitivity (first phase 0.70, final phase 0.71). Hb also correlated well with the Reinhard OW Burk discriminant function of the HRT (0.56), nerve fiber indicator of GDx (-0.64), and vertical C/D ratio of OCT (0.71).
  
  
  CONCLUSIONS
  Hb levels evaluated by color analysis of ONH photographs had high reproducibility, a high sensitivity-specificity balance, and moderate to strong agreement with other structural and functional tests.
authors.affiliation: Hospital Universitario de Canarias, University of La Laguna, La Laguna, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gonzalez de la Rosa
authors.forename: Marta
authors.initials: M
authors.lastname: Gonzalez-Hernandez
authors.forename: Jose
authors.initials: J
authors.lastname: Sigut
authors.forename: Silvia
authors.initials: S
authors.lastname: Alayon
authors.forename: Nathan
authors.initials: N
authors.lastname: Radcliffe
authors.forename: Carmen
authors.initials: C
authors.lastname: Mendez-Hernandez
authors.forename: Julian
authors.initials: J
authors.lastname: García-Feijoo
authors.forename: Isabel
authors.initials: I
authors.lastname: Fuertes-Lazaro
authors.forename: Susana
authors.initials: S
authors.lastname: Perez-Olivan
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferreras
mesh_terms: D005260:Female; D005901:Glaucoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000378:metabolism* / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D057109:Scanning Laser Polarimetry; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*
chemical_list: D006454:Hemoglobins