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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 8/2005

01-08-2005 | Clinical Investigation

Scanning laser polarimetry with variable corneal compensation and detection of glaucomatous optic neuropathy

Authors: Stefano Da Pozzo, Pierluigi Iacono, Roberta Marchesan, Anna Fantin, Giuseppe Ravalico

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2005

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Abstract

Background

The aim of this study was to evaluate the ability of scanning laser polarimetry (SLP) parameters provided by commercially available GDx with variable corneal compensator (VCC) to discriminate between healthy and glaucomatous eyes.

Methods

Sixty-five healthy and 59 glaucomatous age-matched patients underwent a complete ophthalmological evaluation, an achromatic automated perimetry (AAP), and SLP with GDx-VCC. One randomly selected eye from each subject was considered. All glaucomatous eyes had reproducible visual field defects. Mean values (± SD) of all SLP-VCC parameters measured in the two groups were compared. Area under receiver operating characteristics (AUROC) curve and sensitivities at predetermined specificities of ≥80% and ≥95% for each single parameter were calculated. Moreover, the nerve fiber indicator (NFI) diagnostic accuracy was evaluated calculating positive, negative, and interval likelihood ratios (LRs) at different cutoff values.

Results

All SLP parameters were significantly different between the two groups (p<0.001). The NFI showed the best AUROC curve (0.938, SE 0.02) whereas temporal, superior, nasal, inferior, temporal (TSNIT) average was second best (0.897, SE 0.03), and normalized superior area was third (0.879, SE 0.04). At fixed specificity ≥95%, sensitivities ranged from 22% to 79.7% whereas for values ≥80%, sensitivities were in the 44.1–89.8% range. At a cutoff NFI value of 30, positive LR was 17.6 (95% CI: 5.8–53.6) and negative LR was 0.19 (95% CI: 0.11–0.33). Interval LRs for NFI showed that values ≤20 or >40 were associated with large effects on posttest probability.

Conclusions

SLP-VCC allows good discrimination between healthy and glaucomatous eyes. New software-provided parameters NFI, TSNIT average, and normalized superior and inferior areas appear to be reliable in the evaluation of glaucomatous disease. In particular, after evaluation on interval LRs, the NFI showed a high diagnostic accuracy for values ≤20 or >40.
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Metadata
Title
Scanning laser polarimetry with variable corneal compensation and detection of glaucomatous optic neuropathy
Authors
Stefano Da Pozzo
Pierluigi Iacono
Roberta Marchesan
Anna Fantin
Giuseppe Ravalico
Publication date
01-08-2005
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2005
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-004-1118-1

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