Improving glaucoma diagnosis by the combination of structural and functional measurements

Abstract

Abstract Purpose: To determine, whether an appropriate combination of the structural and functional examination methods can improve the diagnosis and follow‐up of glaucoma. Methods: One randomly selected eye of patients with primary open angle glaucoma (POAG) with none or early glaucomatous visual field loss and age‐matched healthy persons were included in the prospective longitudinal study. Structural evaluation was conducted using Heidelberg Retina Tomograph (HRT) and retinal nerve fiber layer (RNFL) loss scoring according to Airaksinen method. Functional evaluation were reviewed by means of standard white‐on white (W/W) perimetry and blue‐on yellow (B/Y)perimetry. Linear discriminant analysis were applied to assess the diagnostic value of different data. The accuracy of discrimination was described and visualized by the Receiver Operating Characteristics Curves (ROC). Results: There were statistically significant differences between healthy and glaucomatous group in the scoring of RNFL loss, HRT parameters (CA,CD,RD,RV,CSM) and W/W perimetry. Parameters with the highest diagnostic ability obtained by ROC curves were scoring of RNFL loss. Conclusions: There were statistically significant differences between healthy and glaucomatous group in the scoring of RNFL loss, HRT parameters (CA,CD,RD,RV,CSM) and W/W perimetry. Parameters with the highest diagnostic ability obtained by ROC curves were scoring of RNFL loss.Supported by IGA NR‐8371