title: Stereometric parameters change vs. Topographic Change Analysis (TCA) agreement in Heidelberg Retina Tomography III (HRT-3) early detection of clinical significant glaucoma progression.
abstract: OBJECTIVE
  to investigate the sensitivity and specificity of the stereometric parameters change analysis vs. Topographic Change Analysis in early detection of glaucoma progression.
  
  
  METHODS
  81 patients with POAG were monitored for 4 years (GAT monthly, SAP at every 6 months, optic disc photographs and HRT3 yearly). The exclusion criteria were other optic disc or retinal pathology; topographic standard deviation (TSD>30; inter-test variation of reference height>25 μm. The criterion for structural progression was the following: at least 20 adjacent super-pixels with a clinically significant decrease in height (>5%).
  
  
  RESULTS
  16 patients of the total 81 presented structural progression on TCA. The most useful stereometric parameters for the early detection of glaucoma progression were the following: Rim Area change (sensitivity 100%, specificity 74.2% for a "cut-off " value of -0.05), C/D Area change (sensitivity 85.7%, specificity 71.5% for a "cut off " value of 0.02), C/D linear change (sensitivity 85.7%, specificity 71.5% for a "cut-off " value of 0.02), Rim Volume change (sensitivity 71.4%, specificity 88.8% for a "cut-off " value of -0.04). RNFL Thickness change (<0) was highly sensitive (82%), but less specific for glaucoma progression (45,2%). Changes of the other stereometric parameters have a limited diagnostic value for the early detection of glaucoma progression.
  
  
  CONCLUSIONS
  TCA is a valuable tool for the assessment of the structural progression in glaucoma patients and its inter-test variability is low. On long-term, the quantitative analysis according to stereometric parameters change is also very important. The most relevant parameters to detect progression are RA, C/D Area, Linear C/D and RV.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: A M
authors.initials: AM
authors.lastname: Dascalu
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: A P
authors.initials: AP
authors.lastname: Cherecheanu
authors.affiliation: University Emergency Hospital, Bucharest, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Stana
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: L
authors.initials: L
authors.lastname: Voinea
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Ciuluvica
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Savlovschi
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Serban
mesh_terms: D019540:Area Under Curve; D018450:Disease Progression; D042241:Early Diagnosis; D005901:Glaucoma / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D012372:ROC Curve; D012160:Retina / Q000473:pathology*; D012680:Sensitivity and Specificity; D014054:Tomography / Q000379:methods*
keywords: Heidelberg retina tomography; glaucoma progression; stereometric parameters