Značaj Pulsar perimetrije u dijagnozi ranog glaukoma

Abstract

Aim: to assess the ability of Pulsar perimetry in detecting an early glaucomatous visual field damage in comparison with Optic coherent tomography (OCT), in early glaucoma. Material: Cross-sectional case study included 1 eye from 55 consecutive subjects containing: 27 healthy subjects and 28 patients with early Primary open angle glaucoma (POAG). Only 1 eye per subject was randomly selected, if both eyes met the inclusion criteria. Methods: All the patients underwent OCT and visual field examination in addition to full ophthalmic examinations. Receiver operating characteristic curves (ROC) were studied for all parameters. The sensitivity and specificity of the differences between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves (AROC) and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters. Results: Individuals with early POAG had significantly higher values of FLV at GCC, MD and sLV at Pulsar perim-etry compared to healthy individuals. There were 1.84% of cases with early glaucoma FLV, whereas there were 0.5% of cases with healthy eyes. Considering Pulsar perimetry, patients with early glaucoma had higher values of MD (0,23dB) and sLV (1,97dB), compared to MD (0,23dB) and sLV (1,62dB) in healthy individuals (p<0.05). The highest values of AROC had the following parametres: FLV AROC (0,648), MD AROC (0,691), sLV AROC (0,696). According to AROC we combined the best three single parameters, FLV at GCC, MD and sLV at Pulsar perimetry, using a logistical diagnostic model. The largest AROC obtained was at the value of 0.790. Conclusion: In conclusion, parameters obtained by OCT (FLV at GCC), and Pulsar perimetry (MD and sLV) were able to show the significant differences between early POAG patients and normal subjects. Combining parameters of FLV at GCC, MD and sLV at Pulsar perimetry showed higher diagnostic capability with those top three single parameters.