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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 11/2009

01-11-2009 | Glaucoma

Reproducibility of color Doppler imaging

Authors: Ingeborg Stalmans, Brent Siesky, Thierry Zeyen, Steffen Fieuws, Alon Harris

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 11/2009

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Abstract

Purpose

The aims of this study were: (1) to determine the intra-subject and inter-observer variability of color Doppler imaging (CDI) measurements and readings of the retrobulbar blood vessels, (2) to compare the difference in variability of CDI parameters in non-glaucomatous controls versus glaucoma patients, and (3) to provide calculations of minimum sample sizes for future CDI studies.

Methods

Patients with normal tension glaucoma (n = 28), primary open-angle glaucoma (n = 19) and non-glaucomatous controls of comparable age (n = 22) underwent CDI on two occasions 1 month apart. Variability in CDI parameters was quantified using (within-subject) coefficients of variation. Based on this variability, minimum sample sizes were calculated to guide the design of future studies comparing CDI between and within groups.

Results

In general, within-subject coefficients of variation for measurements 1 month apart were comparable to previously reported short-term variations. Variability was higher in glaucoma patients than in non-glaucomatous controls. The minimum sample size required for glaucomatous study populations is larger than for non-glaucomatous controls. Smaller patient groups are required to detect change using the peak systolic blood flow velocities than using end diastolic velocities. Studies using a cross-over design require smaller sample sizes than studies with a pre-post or particularly parallel design.

Conclusions

This study provides extensive information on long-term intra-subject variability of CDI measurements in non-glaucomatous controls as well as glaucoma patients. Moreover, sample size calculations are provided for studies involving glaucoma patients as well as non-glaucomatous individuals, using three different commonly used study designs.
Footnotes
1
For EDV and PSV, considered effect sizes are differences between parallel groups in pre-post ratio of the means. For example, suppose that the ratio between the pre- and post condition in the first group is c times higher than in the second group; this implies a difference in change of ln(c) on the log-scale. With y 0 and y 1 the pre- and post-measurement in one group and x 0 and x 1 the pre- and post-measurement in the other group: \( \left\{ {\ln \left( {y_1} \right) - \ln \left( {y_0} \right)} \right\} - \left\{ {\ln \left( {x_1} \right) - \ln \left( {x_0} \right)} \right\} = \ln \left( {{{y_1} \mathord{\left/{\vphantom {{y_1} {y_0}}} \right.} {y_0}}} \right) - \ln \left( {{{x_1} \mathord{\left/{\vphantom {{x_1} {x_0}}} \right.} {x_0}}} \right) = \ln \left( {\frac{{{{y_1} \mathord{\left/{\vphantom {{y_1} {y_0}}} \right.} {y_0}}}}{{{{x_1} \mathord{\left/{\vphantom {{x_1} {x_0}}} \right.} {x_0}}}}} \right) \). For c= 1.05, 1.10, 1.15 and 1.20, the difference in changes on the log-scale are 0.049, 0.095, 0.140 and 0.182 respectively.
 
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Metadata
Title
Reproducibility of color Doppler imaging
Authors
Ingeborg Stalmans
Brent Siesky
Thierry Zeyen
Steffen Fieuws
Alon Harris
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 11/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-009-1178-3

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