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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Glaucoma
2017 ; 26
(5
): 498-504
Nephropedia Template TP
gab.com Text
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English Wikipedia
The Association Between Clinical Features Seen on Fundus Photographs and
Glaucomatous Damage Detected on Visual Fields and Optical Coherence Tomography
Scans
#MMPMID28333890
Alhadeff PA
; De Moraes CG
; Chen M
; Raza AS
; Ritch R
; Hood DC
J Glaucoma
2017[May]; 26
(5
): 498-504
PMID28333890
show ga
PURPOSE: To classify the appearance of the optic disc seen on fundus photographs
of healthy subjects and patients with or suspected glaucoma whose diagnosis was
based upon visual fields (VFs) and spectral-domain optical coherence tomography
(sdOCT) results. PATIENTS AND METHODS: One eye of 100 patients with or suspected
glaucoma and 62 healthy subjects were prospectively tested with 24-2 and 10-2 VF
and macular and disc sdOCT cube scans. All eyes with or suspected glaucoma had a
24-2 mean deviation better than -6.0 dB and an abnormal appearing disc on
stereophotographs. The retinal ganglion cell plus inner plexiform layer (RGC+)
from the macular scans and the retinal nerve fiber layer (RNFL) from the macular
and disc scans were segmented and converted to probabilities plots. An eye was
considered "glaucoma" if the sdOCT probability plots showed an abnormality in a
region that corresponded to a defect seen on the 24-2 and/or 10-2 VF total
deviation plot. Similarly, an eye was considered "suspect" only if both the sdOCT
and VF plots were normal. Healthy subjects (normal VFs and sdOCT) were classified
as "controls" and used as reference for comparisons. Glaucoma specialists
reviewed the stereophotographs and classified eyes based on the presence of signs
suggestive of glaucomatous optic neuropathy. RESULTS: The pattern of clinical
signs of glaucomatous optic neuropathy seen on stereophotographs was
statistically different between glaucoma (P<0.001) and suspects (P<0.001) vs.
controls and explained up to 68% of the total variance of the diagnosis based
upon sdOCT and VFs. Vertical cup-to-disc>0.6, focal neuroretinal rim thinning,
focal RNFL loss, and violation of the ISNT rule had the best performance to
differentiate glaucoma and suspects from controls. Compared with the suspect
group, glaucoma eyes (abnormal sdOCT and VF tests) were more likely to have
vertical cup-to-disc>0.6 (92% vs. 69%, P=0.003), diffuse rim (53% vs. 9%,
P<0.001) and RNFL (61% vs. 26%, P<0.001) thinning, and ?-zone parapapillary
atrophy (68% vs. 17%, P<0.001). CONCLUSIONS: Focal and diffuse signs of glaucoma
damage seen on stereophotographs often match damage shown on VFs and sdOCT. In
addition, damage shown on VFs and sdOCT is often missed during clinical
evaluation. Longitudinal studies ought to differentiate focal signs of glaucoma
damage seen on stereophotography from false-positives or very early loss.