[Sensitivity and Specificity of the Nerve Fibre Imaging Using Scanning Laser Ophthalmoscopy and of Optic Nerve Analysis Using Heidelberg Retina Tomography in Glaucoma].
OBJECTIVE
Imaging of the optic nerve head and the nerve fibre layer are used in the diagnosis of glaucoma. We have investigated the diagnostic precision of nerve fibre layer imaging using a manually operated scanning laser ophthalmoscope and analysis of the optic nerve head using the Heidelberg Retina Tomograph II (HRT).


METHODS
42 patients with glaucoma, 16 patients with ocular hypertension (OHT) and 24 healthy control subjects were included in a clinical study. Nerve fibre layer imaging was performed using a scanning laser ophthalmoscope (SLO, Rodenstock Instr. argon laser 488 nm). Nerve fibre layer defects were analysed peripapillarily for every single degree (defect or no defect) at 1.7 mm (near) and at 3.4 mm (far) distance to the optic nerve head. Specificity and sensitivity of the HRT II were calculated using the Moorfields regression analysis (MRA).


RESULTS
Patients with glaucoma were found to have 109 ± 92° (near) and 109 ± 92° (far) defects of the nerve fibre layer. Patients with OHT (8 ± 14° [far] and 6 ± 11° [near]) and control subjects (0 ± 0° [far] and 0 ± 1° [near]) showed significantly smaller defects (p < 0.0001). Sensitivity at > 90 % specificity for POAG and controls was 85.7 % (far) and 82.9 % (near). Sensitivity at > 90 % specifity for OHT and POAG was 85.7 % (far) und 82.9 % (near). Specificity of controls for the MRA was 83.3 % (borderline classified as normal). Specificity of OHT patients was 93.8 % (borderline classified normal). Sensitivity of the MRA for POAG was 80.9 % (borderline classified normal) and 90.5 % (borderline classified glaucoma).


CONCLUSIONS
Nerve fiber layer imaging using a manually operated scanning laser ophthalmoscope was found to achieve a higher diagnostic precision as compared to optic disc evaluation using the HRT II.
Augenheilkunde, Uniklinik RWTH Aachen.
T
T
Hirsch
Anästhesiologie, Uniklinik RWTH Aachen.
F
F
Hirsch
Augenheilkunde, Uniklinik RWTH Aachen.
E C
EC
Koch
Augenheilkunde, Uniklinik RWTH Aachen.
M
M
Fuest
Augenheilkunde, Uniklinik RWTH Aachen.
N
N
Plange
D005260:Female; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009887:Ophthalmoscopy / Q000379:methods*; D009900:Optic Nerve / Q000473:pathology*; D015203:Reproducibility of Results; D012160:Retina / Q000473:pathology; D057109:Scanning Laser Polarimetry / Q000379:methods*; D012680:Sensitivity and Specificity; D041622:Tomography, Optical / Q000379:methods*