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Diagnostic accuracy of the GDx VCC for glaucoma.
Ophthalmology. 2004 Oct; 111(10):1860-5.O

Abstract

PURPOSE

To determine the diagnostic accuracy of the GDx VCC in the diagnosis of glaucoma.

DESIGN

Prospective, comparative, observational, clinic-based case series.

PARTICIPANTS

One eye each of 77 healthy subjects and 162 patients with primary open-angle glaucoma of Caucasian racial origin. Healthy subjects had normal visual fields (VFs), healthy-looking optic discs, and intraocular pressures of < or =21 mmHg in both eyes. Glaucoma patients had a reproducible glaucomatous VF defect and a glaucomatous appearance of the optic disc in at least one eye.

METHODS

All subjects were measured with the GDx VCC with an automated variable corneal compensator. We constructed receiver operating characteristic (ROC) curves for all available parameters. Subsequently, we calculated sensitivity, specificity, and multilevel likelihood ratios for the best discriminating parameter in the entire group. In addition, we calculated sensitivity and specificity in patients with mild, moderate, and severe glaucomatous damage separately.

MAIN OUTCOME MEASURES

Software-derived parameters TSNIT (temporal, superior, nasal, inferior, temporal) Average, Superior Average, Inferior Average, TSNIT Std. Dev. (standard deviation), and Nerve Fiber Indicator (NFI).

RESULTS

The areas under the ROC curve for TSNIT Average, Superior Average, Inferior Average, TSNIT Std. Dev., and NFI were 0.93, 0.94, 0.90, 0.92, and 0.98, respectively. For the best discriminating parameter NFI, the sensitivity and specificity with a cutoff point of > or =40 were 89.0% and 95.9%, respectively. The multilevel likelihood ratios for glaucoma were 0.07 at NFI values of <35, 1.30 at values between 35 and 44, and 61.50 at values of > or =44. At the cutoff level of > or =40, the sensitivities of the NFI for correctly identifying glaucoma patients with mild, moderate, and severe damage were 83.8%, 92.9%, and 90.1%, respectively.

CONCLUSIONS

The GDx VCC allowed easy, rapid, and accurate discrimination between healthy and glaucomatous eyes. The NFI was the best discriminating parameter. The GDx VCC seems to fulfill criteria for a glaucoma screening device.

Authors+Show Affiliations

Glaucoma Service, The Rotterdam Eye Hospital, Rotterdam, The Netherlands. reus@oogziekenhuis.nlNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15465547

Citation

Reus, Nicolaas J., and Hans G. Lemij. "Diagnostic Accuracy of the GDx VCC for Glaucoma." Ophthalmology, vol. 111, no. 10, 2004, pp. 1860-5.
Reus NJ, Lemij HG. Diagnostic accuracy of the GDx VCC for glaucoma. Ophthalmology. 2004;111(10):1860-5.
Reus, N. J., & Lemij, H. G. (2004). Diagnostic accuracy of the GDx VCC for glaucoma. Ophthalmology, 111(10), 1860-5.
Reus NJ, Lemij HG. Diagnostic Accuracy of the GDx VCC for Glaucoma. Ophthalmology. 2004;111(10):1860-5. PubMed PMID: 15465547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of the GDx VCC for glaucoma. AU - Reus,Nicolaas J, AU - Lemij,Hans G, PY - 2003/12/17/received PY - 2004/04/19/accepted PY - 2004/10/7/pubmed PY - 2004/10/22/medline PY - 2004/10/7/entrez SP - 1860 EP - 5 JF - Ophthalmology JO - Ophthalmology VL - 111 IS - 10 N2 - PURPOSE: To determine the diagnostic accuracy of the GDx VCC in the diagnosis of glaucoma. DESIGN: Prospective, comparative, observational, clinic-based case series. PARTICIPANTS: One eye each of 77 healthy subjects and 162 patients with primary open-angle glaucoma of Caucasian racial origin. Healthy subjects had normal visual fields (VFs), healthy-looking optic discs, and intraocular pressures of < or =21 mmHg in both eyes. Glaucoma patients had a reproducible glaucomatous VF defect and a glaucomatous appearance of the optic disc in at least one eye. METHODS: All subjects were measured with the GDx VCC with an automated variable corneal compensator. We constructed receiver operating characteristic (ROC) curves for all available parameters. Subsequently, we calculated sensitivity, specificity, and multilevel likelihood ratios for the best discriminating parameter in the entire group. In addition, we calculated sensitivity and specificity in patients with mild, moderate, and severe glaucomatous damage separately. MAIN OUTCOME MEASURES: Software-derived parameters TSNIT (temporal, superior, nasal, inferior, temporal) Average, Superior Average, Inferior Average, TSNIT Std. Dev. (standard deviation), and Nerve Fiber Indicator (NFI). RESULTS: The areas under the ROC curve for TSNIT Average, Superior Average, Inferior Average, TSNIT Std. Dev., and NFI were 0.93, 0.94, 0.90, 0.92, and 0.98, respectively. For the best discriminating parameter NFI, the sensitivity and specificity with a cutoff point of > or =40 were 89.0% and 95.9%, respectively. The multilevel likelihood ratios for glaucoma were 0.07 at NFI values of <35, 1.30 at values between 35 and 44, and 61.50 at values of > or =44. At the cutoff level of > or =40, the sensitivities of the NFI for correctly identifying glaucoma patients with mild, moderate, and severe damage were 83.8%, 92.9%, and 90.1%, respectively. CONCLUSIONS: The GDx VCC allowed easy, rapid, and accurate discrimination between healthy and glaucomatous eyes. The NFI was the best discriminating parameter. The GDx VCC seems to fulfill criteria for a glaucoma screening device. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/15465547/Diagnostic_accuracy_of_the_GDx_VCC_for_glaucoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(04)00820-6 DB - PRIME DP - Unbound Medicine ER -