1.Correlation of structure and function in glaucoma
Maria Joanna Rodriguez-Chan ; Patricia M. Khu ; Ma. Margarita L. Luna ; Manuel B. Agulto
Philippine Journal of Ophthalmology 2009;34(1):15-18
Objective:
This study assessed the relationship of two structural tests, optic-disc
photography and optical coherence tomography (OCT), and a functional
test, standard achromatic perimetry (SAP), in the diagnosis of glaucoma.
Methods:
A retrospective review of charts from the database of a private glaucoma
specialist and the glaucoma clinic of a tertiary hospital was done. The participants were longitudinally evaluated and had comprehensive eye examination,
imaging, and functional testing. Optic-disc photographs, OCTs, and SAPs were
interpreted and evaluated separately, and then correlated with each other by
two glaucoma experts working individually. Sensitivities, specificities, and
predictive values were obtained for each diagnostic test and in combination.
Kappa statistics were used for interobserver agreement.
Results:
Three hundred sixty-seven eyes of 188 patients were included in the study.
Fifty-eight patients were diagnosed as normal, 130 had glaucoma. OCT had
the highest sensitivity and specificity at 70.7% and 76.6%, followed by SAP at
72.4% and 53.5% respectively. Optic-disc photos had the lowest sensitivity and
specificity at 55.8% and 54.4% respectively, and the lowest interobserver
agreement (kappa = 0.50-0.61). The predictive values of the 3 tests increased
to 82% with good interobserver agreement (kappa = 0.68-0.78) when
correlated with each other.
Conclusion
The correlation of structural and functional tests increased the accuracy of
diagnosing glaucoma. These examinations offered complementary
information and, when used in conjunction with comprehensive clinical
evaluation, guided the clinician in the proper management of patients with
glaucoma.
Glaucoma Optic Disk Tomography
;
Optical Coherence Visual Fields