title: Diagnostic Accuracy of the Spectralis and Cirrus Reference Databases in Differentiating between Healthy and Early Glaucoma Eyes.
abstract: OBJECTIVE
  To evaluate and compare the diagnostic accuracy of global and sector analyses for detection of early visual field (VF) damage using the retinal nerve fiber layer (RNFL) reference databases of the Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Cirrus (Carl Zeiss Meditec, Dublin, CA) spectral-domain optical coherence tomography (SD OCT) devices.
  
  
  METHODS
  Healthy subjects and glaucoma suspects from the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES) with at least 2 years of follow-up were included. Global and sectoral RNFL measures were classified as within normal limits, borderline (BL), and outside normal limits (ONL) on the basis of the device reference databases. The sensitivity of ONL classification was estimated in glaucoma suspect eyes that developed repeatable VF damage.
  
  
  RESULTS
  A total of 353 glaucoma suspect eyes and 279 healthy eyes were included. A total of 34 (9.6%) of the glaucoma suspect eyes developed VF damage. In glaucoma suspect eyes, Spectralis and Cirrus ONL classification was present in 47 eyes (13.3%) and 24 eyes (6.8%), respectively. The sensitivity of the global RNFL ONL classification among eyes that developed VF damage was 23.5% for Cirrus and 32.4% for Spectralis. The specificity of within-normal-limits global classification in healthy eyes was 100% for Cirrus and 99.6% for Spectralis. There was moderate to substantial agreement between Cirrus and Spectralis classification as ONL.
  
  
  CONCLUSIONS
  The Spectralis and Cirrus reference databases have a high specificity for identifying healthy eyes and good agreement for detection of eyes with early glaucoma damage.
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California; George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Silverman
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
authors.forename: Naama
authors.initials: N
authors.lastname: Hammel
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
authors.forename: Naira
authors.initials: N
authors.lastname: Khachatryan
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
authors.forename: Lucie
authors.initials: L
authors.lastname: Sharpsten
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.affiliation: School of Medicine, University of Alabama, Birmingham, Alabama.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Girkin
authors.affiliation: Harkness Eye Institute, Columbia University Medical Center, New York, New York.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
authors.affiliation: Department of Ophthalmology, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California. Electronic address: lzangwill@ucsd.edu.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Zangwill
mesh_terms: D001741:Black or African American / Q000208:ethnology; D000368:Aged; D016208:Databases, Factual; D042241:Early Diagnosis; D006068:Gonioscopy; D064368:Healthy Volunteers; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000208:ethnology; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000295:instrumentation* / Q000379:methods; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests; D014794:Visual Fields