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Glaucoma follow-up by the Heidelberg retina tomograph--new graphical analysis of optic disc topography changes.

Artikel i vetenskaplig tidskrift
Författare Lada Kalaboukhova
Vanja Fridhammar
Bertil Lindblom
Publicerad i Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie
Volym 244
Nummer/häfte 6
Sidor 654-62
ISSN 0721-832X
Publiceringsår 2006
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Sidor 654-62
Språk en
Länkar dx.doi.org/10.1007/s00417-005-0107-...
Ämnesord Aged, Diagnostic Techniques, Ophthalmological, instrumentation, Disease Progression, Female, Follow-Up Studies, Glaucoma, Open-Angle, diagnosis, Humans, Intraocular Pressure, Male, Ocular Hypertension, diagnosis, Optic Disk, pathology, Optic Nerve Diseases, diagnosis, Photography, Retrospective Studies, Tomography, methods, Vision Disorders, diagnosis, Visual Fields
Ämneskategorier Oftalmiatrik

Sammanfattning

BACKGROUND: The Heidelberg Retina Tomograph (HRT) is a commercially available instrument for the detection of glaucomatous damage by analysis of optic nerve head topography. The main purpose of the study was to investigate the ability of HRT to detect changes in optic disc topography indicating progression of optic neuropathy in eyes with open-angle glaucoma or, in eyes with ocular hypertension, conversion to open-angle glaucoma. METHODS: Fifty-nine subjects (34 with ocular hypertension, 25 with glaucoma) from the glaucoma service at Sahlgrenska University Hospital were included in this study. One eye of each patient was selected. All participants underwent thorough clinical examination, including HRT, high-pass resolution perimetry (HRP), and optic disk photography. After a mean follow-up time of 50 months, patients were re-examined. Based on analyses of optic disc photographs and HRP, eyes were classified into one of two groups: progressive or stable. The differences between baseline and follow-up HRT parameters in the two groups were analysed. The topographic HRT change images were also compared after digital image processing. A pixel ratio was calculated defined as the ratio between the area of pixels representing deepening of the disc surface and the total disc area. Receiver operating characteristic (ROC) curves for HRT parameters and pixel ratio were compared. RESULTS: In the group judged to have progressive optic neuropathy, a statistically significant change between baseline and follow-up examination was found for the following HRT parameters: cup shape measurement, classification index, the third moment in contour, cup/disc ratio, cup area, rim area, and area below reference). In the stable group no HRT parameters had changed significantly. A well-defined distinction between the two groups was found by comparing digitally processed HRT change images. The area under the ROC curve was larger for pixel ratio than for any of the HRT parameters. CONCLUSIONS: The HRT is a useful tool for long-term follow-up of glaucomatous optic neuropathy. Digital image processing of HRT change images could facilitate the detection of progressive change.

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