The Groningen Longitudinal Glaucoma Study. I. Baseline sensitivity and specificity of the frequency doubling perimeter and the GDx nerve fibre analyser

Abstract

To describe the baseline data of a large cohort of patients included for follow-up with perimetry using the frequency doubling technique (FDT) and with quantification of the retinal nerve fibre layer as assessed by GDx, and to calculate the sensitivity and specificity of both devices from these baseline data. Regular visitors to our glaucoma service were included. All subjects were followed for at least 4 years with FDT in full-threshold mode, GDx and conventional perimetry. Patients were classified as having either glaucoma or suspect glaucoma, according to baseline perimetry results. In addition, a group of healthy subjects was recruited outside the hospital. A total of 452 glaucoma patients, 423 glaucoma suspects and 237 healthy subjects were incorporated into the analyses. Sensitivities for both FDT and GDx were fixed at 0.90. For the group as a whole, the specificity was 0.81 for FDT, using number of depressed test-points p < 0.01 in the total deviation probability plot with a cut-off point > 1, and 0.78 for GDx, using the Number, with a cut-off point > 29. The area under the receiver operating characteristic (ROC) curve was 0.92 for FDT and 0.94 for GDx. Of the subjects with suspect glaucoma, 75% showed normal FDT test results and 52% showed normal GDx results. Unlike FDT, GDx failed to detect some moderate/severe glaucoma cases. The performances of FDT and GDx are approximately equivalent in terms of sensitivity, specificity and area under the ROC curve. In glaucoma suspects, GDx in particular yielded a rather high percentage of positive test results. The majority of these positive test results are presumably false-positive results rather than results indicating preperimetric glaucoma.