Combined structure–function analysis in glaucoma screening
Aim To assess the applicability of a structure–function (S-F) analysis combining spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP) in glaucoma screening in a middle-aged population. Methods A randomised sample of 3001 Caucasian participants aged 45–49 years...
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crjcrbmj:10.1136/bjophthalmol-2021-319178 2024-04-07T07:54:49+00:00 Combined structure–function analysis in glaucoma screening Karvonen, Elina Stoor, Katri Luodonpää, Marja Hägg, Pasi Leiviskä, Ilmari Liinamaa, Johanna Tuulonen, Anja Saarela, Ville Association of the Finnish Ophthalmologists, Helsinki, Finland Oulu University Hospital, Oulu, Finland Glaukooma Tukisäätiö (Glaucoma Support) Lux Foundation, Helsinki, Finland University of Oulu, Oulu, Finland Tampere University Hospital, Tampere, Finland Sokeain Ystävät (Friends of Blind Persons) Foundation, Helsinki, Finland ERDF European Regional Development Fund Grant Silmäsäätiö (Eye) Foundation, Helsinki, Finland 2021 http://dx.doi.org/10.1136/bjophthalmol-2021-319178 https://syndication.highwire.org/content/doi/10.1136/bjophthalmol-2021-319178 en eng BMJ British Journal of Ophthalmology volume 106, issue 12, page 1689-1695 ISSN 0007-1161 1468-2079 Cellular and Molecular Neuroscience Sensory Systems Ophthalmology journal-article 2021 crjcrbmj https://doi.org/10.1136/bjophthalmol-2021-319178 2024-03-08T02:42:46Z Aim To assess the applicability of a structure–function (S-F) analysis combining spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP) in glaucoma screening in a middle-aged population. Methods A randomised sample of 3001 Caucasian participants aged 45–49 years of the Northern Finland Birth Cohort Eye Study was examined. We performed an eye examination, including 24–2 SAP, optic nerve head (ONH) and retinal nerve fibre layer (RNFL) photography and SD-OCT of the peripapillary RNFL. The S-F report was generated by Forum Glaucoma Workplace software. OCT, SAP and the S-F analysis were evaluated against clinical glaucoma diagnosis, that is, the positive ‘2 out of 3’ rule based on the clinician’s evaluation of ONH and RNFL photographs and visual fields (VFs). Results At a specificity of 97.5%, the sensitivity for glaucomatous damage was 26% for abnormal OCT, 35% for SAP and 44% for S-F analysis. Estimated areas under the curve were 0.74, 0.85 and 0.76, and the corresponding positive predictive values were 8 %, 10% and 12%, respectively. By applying a classification tree approach combining OCT, SAP and defect localisation data, a sensitivity of 77% was achieved at 90% specificity. In a localisation analysis of glaucomatous structural and functional defects, the correlation with glaucoma increased significantly if the abnormal VF test points were located on borderline or abnormal OCT zones. Conclusion SAP performs slightly better than OCT in glaucoma screening of middle-aged population. However, the diagnostic capability can be improved by S-F analysis. Article in Journal/Newspaper Northern Finland The BMJ British Journal of Ophthalmology bjophthalmol-202 |
institution |
Open Polar |
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The BMJ |
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crjcrbmj |
language |
English |
topic |
Cellular and Molecular Neuroscience Sensory Systems Ophthalmology |
spellingShingle |
Cellular and Molecular Neuroscience Sensory Systems Ophthalmology Karvonen, Elina Stoor, Katri Luodonpää, Marja Hägg, Pasi Leiviskä, Ilmari Liinamaa, Johanna Tuulonen, Anja Saarela, Ville Combined structure–function analysis in glaucoma screening |
topic_facet |
Cellular and Molecular Neuroscience Sensory Systems Ophthalmology |
description |
Aim To assess the applicability of a structure–function (S-F) analysis combining spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP) in glaucoma screening in a middle-aged population. Methods A randomised sample of 3001 Caucasian participants aged 45–49 years of the Northern Finland Birth Cohort Eye Study was examined. We performed an eye examination, including 24–2 SAP, optic nerve head (ONH) and retinal nerve fibre layer (RNFL) photography and SD-OCT of the peripapillary RNFL. The S-F report was generated by Forum Glaucoma Workplace software. OCT, SAP and the S-F analysis were evaluated against clinical glaucoma diagnosis, that is, the positive ‘2 out of 3’ rule based on the clinician’s evaluation of ONH and RNFL photographs and visual fields (VFs). Results At a specificity of 97.5%, the sensitivity for glaucomatous damage was 26% for abnormal OCT, 35% for SAP and 44% for S-F analysis. Estimated areas under the curve were 0.74, 0.85 and 0.76, and the corresponding positive predictive values were 8 %, 10% and 12%, respectively. By applying a classification tree approach combining OCT, SAP and defect localisation data, a sensitivity of 77% was achieved at 90% specificity. In a localisation analysis of glaucomatous structural and functional defects, the correlation with glaucoma increased significantly if the abnormal VF test points were located on borderline or abnormal OCT zones. Conclusion SAP performs slightly better than OCT in glaucoma screening of middle-aged population. However, the diagnostic capability can be improved by S-F analysis. |
author2 |
Association of the Finnish Ophthalmologists, Helsinki, Finland Oulu University Hospital, Oulu, Finland Glaukooma Tukisäätiö (Glaucoma Support) Lux Foundation, Helsinki, Finland University of Oulu, Oulu, Finland Tampere University Hospital, Tampere, Finland Sokeain Ystävät (Friends of Blind Persons) Foundation, Helsinki, Finland ERDF European Regional Development Fund Grant Silmäsäätiö (Eye) Foundation, Helsinki, Finland |
format |
Article in Journal/Newspaper |
author |
Karvonen, Elina Stoor, Katri Luodonpää, Marja Hägg, Pasi Leiviskä, Ilmari Liinamaa, Johanna Tuulonen, Anja Saarela, Ville |
author_facet |
Karvonen, Elina Stoor, Katri Luodonpää, Marja Hägg, Pasi Leiviskä, Ilmari Liinamaa, Johanna Tuulonen, Anja Saarela, Ville |
author_sort |
Karvonen, Elina |
title |
Combined structure–function analysis in glaucoma screening |
title_short |
Combined structure–function analysis in glaucoma screening |
title_full |
Combined structure–function analysis in glaucoma screening |
title_fullStr |
Combined structure–function analysis in glaucoma screening |
title_full_unstemmed |
Combined structure–function analysis in glaucoma screening |
title_sort |
combined structure–function analysis in glaucoma screening |
publisher |
BMJ |
publishDate |
2021 |
url |
http://dx.doi.org/10.1136/bjophthalmol-2021-319178 https://syndication.highwire.org/content/doi/10.1136/bjophthalmol-2021-319178 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
British Journal of Ophthalmology volume 106, issue 12, page 1689-1695 ISSN 0007-1161 1468-2079 |
op_doi |
https://doi.org/10.1136/bjophthalmol-2021-319178 |
container_title |
British Journal of Ophthalmology |
container_start_page |
bjophthalmol-202 |
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1795671608938987520 |