Diagnostic Ability of the Heidelberg Retina Tomograph, Optical Coherence Tomograph, and Scanning Laser Polarimeter in Open-angle Glaucoma

Abstract

To compare the ability to discriminate between healthy and glaucomatous eyes of different criteria based on parameters from 3 optical imaging devices: Heidelberg retina tomograph (HRT-II), optical coherence tomograph (Stratus OCT 3000) and scanning laser polarimeter (GDx VCC). Cross-sectional study. A total of 139 eyes from 139 subjects were enrolled in this study and classified into 66 healthy subjects and 73 glaucomatous patients according to intraocular pressure and standard automated perimetry. All the subjects underwent complete ophthalmic examination, including HRT-II, OCT, and GDx VCC evaluations. Several parameters were obtained by these techniques and 8 diagnostic criteria were assessed. Receiver operating characteristics curves were plotted and compared among them, and sensitivity for specificity higher than 95% was calculated for every criterion. Agreement among the 3 technologies was assessed by means of Venn diagrams. The best criteria discriminating between healthy and glaucomatous eyes were Moorfields regression analysis out of the 95% confidence interval (HRT-II), OCT retinal nerve fiber layer average thickness <77 microm, and nerve fiber indicator >37 (GDx VCC) with sensitivities of 85%, 66%, and 48%, with specificity higher than 95%. Sixty-six patients out of 73 were correctly identified by at least 1 of the devices and 30 were detected by the 3 of them. Structural criteria assessed by the optical imaging devices evaluated in this study are useful to discriminate glaucomatous damage.