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Scanning laser polarimetry using variable corneal compensation in the detection of glaucoma with localized visual field defects.
Ophthalmology. 2005 Nov; 112(11):1970-8.O

Abstract

PURPOSE

To evaluate the ability of scanning laser polarimetry parameters and a novel deviation map algorithm to discriminate between healthy and early glaucomatous eyes with localized visual field (VF) defects confined to one hemifield.

DESIGN

Prospective case-control study.

PARTICIPANTS

Seventy glaucomatous eyes with localized VF defects and 66 normal controls.

METHODS

A Humphrey field analyzer 24-2 full-threshold test and scanning laser polarimetry with variable corneal compensation were used.

MAIN OUTCOME MEASURES

We assessed the sensitivity and specificity of scanning laser polarimetry parameters, sensitivity and cutoff values for scanning laser polarimetry deviation map algorithms at different specificity values (80%, 90%, and 95%) in the detection of glaucoma, and correlations between the algorithms of scanning laser polarimetry and of the pattern deviation derived from Humphrey field analyzer testing.

RESULTS

There were significant differences between the glaucoma group and normal subjects in the mean parametric values of the temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average, inferior average, and TSNIT standard deviation (SD) (P<0.05). The sensitivity and specificity of each scanning laser polarimetry variable was as follows: TSNIT, 44.3% (95% confidence interval [CI], 39.8%-49.8%) and 100% (95.4%-100%); superior average, 30% (25.5%-34.5%) and 97% (93.5%-100%); inferior average, 45.7% (42.2%-49.2%) and 100% (95.8%-100%); and TSNIT SD, 30% (25.9%-34.1%) and 97% (93.2%-100%), respectively (when abnormal was defined as P<0.05). Based on nerve fiber indicator cutoff values of > or =30 and > or =51 to indicate glaucoma, sensitivities were 54.3% (50.1%-58.5%) and 10% (6.4%-13.6%), and specificities were 97% (93.2%-100%) and 100% (95.8%-100%), respectively. The range of areas under the receiver operating characteristic curves using the scanning laser polarimetry deviation map algorithm was 0.790 to 0.879. Overall sensitivities combining each probability scale and severity score at 80%, 90%, and 95% specificities were 90.0% (95% CI, 86.4%-93.6%), 71.4% (67.4%-75.4%), and 60.0% (56.2%-63.8%), respectively. There was a statistically significant correlation between the scanning laser polarimetry severity score and the VF severity score (R2 = 0.360, P<0.001).

CONCLUSIONS

Scanning laser polarimetry parameters may not be sufficiently sensitive to detect glaucomatous patients with localized VF damage. Our algorithm using the scanning laser polarimetry deviation map may enhance the understanding of scanning laser polarimetry printouts in terms of the locality, deviation size, and severity of localized retinal nerve fiber layer defects in eyes with localized VF loss.

Authors+Show Affiliations

Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. mskook@amc.seoul.krNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16185765

Citation

Kook, Michael S., et al. "Scanning Laser Polarimetry Using Variable Corneal Compensation in the Detection of Glaucoma With Localized Visual Field Defects." Ophthalmology, vol. 112, no. 11, 2005, pp. 1970-8.
Kook MS, Cho HS, Seong M, et al. Scanning laser polarimetry using variable corneal compensation in the detection of glaucoma with localized visual field defects. Ophthalmology. 2005;112(11):1970-8.
Kook, M. S., Cho, H. S., Seong, M., & Choi, J. (2005). Scanning laser polarimetry using variable corneal compensation in the detection of glaucoma with localized visual field defects. Ophthalmology, 112(11), 1970-8.
Kook MS, et al. Scanning Laser Polarimetry Using Variable Corneal Compensation in the Detection of Glaucoma With Localized Visual Field Defects. Ophthalmology. 2005;112(11):1970-8. PubMed PMID: 16185765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scanning laser polarimetry using variable corneal compensation in the detection of glaucoma with localized visual field defects. AU - Kook,Michael S, AU - Cho,Hyun-soo, AU - Seong,Mincheol, AU - Choi,Jaewan, Y1 - 2005/09/26/ PY - 2004/12/17/received PY - 2005/06/02/accepted PY - 2005/9/28/pubmed PY - 2005/12/13/medline PY - 2005/9/28/entrez SP - 1970 EP - 8 JF - Ophthalmology JO - Ophthalmology VL - 112 IS - 11 N2 - PURPOSE: To evaluate the ability of scanning laser polarimetry parameters and a novel deviation map algorithm to discriminate between healthy and early glaucomatous eyes with localized visual field (VF) defects confined to one hemifield. DESIGN: Prospective case-control study. PARTICIPANTS: Seventy glaucomatous eyes with localized VF defects and 66 normal controls. METHODS: A Humphrey field analyzer 24-2 full-threshold test and scanning laser polarimetry with variable corneal compensation were used. MAIN OUTCOME MEASURES: We assessed the sensitivity and specificity of scanning laser polarimetry parameters, sensitivity and cutoff values for scanning laser polarimetry deviation map algorithms at different specificity values (80%, 90%, and 95%) in the detection of glaucoma, and correlations between the algorithms of scanning laser polarimetry and of the pattern deviation derived from Humphrey field analyzer testing. RESULTS: There were significant differences between the glaucoma group and normal subjects in the mean parametric values of the temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average, inferior average, and TSNIT standard deviation (SD) (P<0.05). The sensitivity and specificity of each scanning laser polarimetry variable was as follows: TSNIT, 44.3% (95% confidence interval [CI], 39.8%-49.8%) and 100% (95.4%-100%); superior average, 30% (25.5%-34.5%) and 97% (93.5%-100%); inferior average, 45.7% (42.2%-49.2%) and 100% (95.8%-100%); and TSNIT SD, 30% (25.9%-34.1%) and 97% (93.2%-100%), respectively (when abnormal was defined as P<0.05). Based on nerve fiber indicator cutoff values of > or =30 and > or =51 to indicate glaucoma, sensitivities were 54.3% (50.1%-58.5%) and 10% (6.4%-13.6%), and specificities were 97% (93.2%-100%) and 100% (95.8%-100%), respectively. The range of areas under the receiver operating characteristic curves using the scanning laser polarimetry deviation map algorithm was 0.790 to 0.879. Overall sensitivities combining each probability scale and severity score at 80%, 90%, and 95% specificities were 90.0% (95% CI, 86.4%-93.6%), 71.4% (67.4%-75.4%), and 60.0% (56.2%-63.8%), respectively. There was a statistically significant correlation between the scanning laser polarimetry severity score and the VF severity score (R2 = 0.360, P<0.001). CONCLUSIONS: Scanning laser polarimetry parameters may not be sufficiently sensitive to detect glaucomatous patients with localized VF damage. Our algorithm using the scanning laser polarimetry deviation map may enhance the understanding of scanning laser polarimetry printouts in terms of the locality, deviation size, and severity of localized retinal nerve fiber layer defects in eyes with localized VF loss. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16185765/Scanning_laser_polarimetry_using_variable_corneal_compensation_in_the_detection_of_glaucoma_with_localized_visual_field_defects_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(05)00888-2 DB - PRIME DP - Unbound Medicine ER -