Comparison between Heidelberg Retina Tomograph 2 and Heidelberg Retina Tomograph 3 for Glaucoma Detection

Mee Yon Lee; Na Young Lee; Chan Kee Park

doi:10.3341/jkos.2008.49.8.1303

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008052

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Lee, and Park: Comparison between Heidelberg Retina Tomograph 2 and Heidelberg Retina Tomograph 3 for Glaucoma Detection

Original Article

J Korean Ophthalmol Soc 2008;49(8):1303-1308.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1303

Comparison between Heidelberg Retina Tomograph 2 and Heidelberg Retina Tomograph 3 for Glaucoma Detection

Mee Yon Lee, M.D., Na Young Lee, M.D., Chan Kee Park, M.D.

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Chan Kee Park, M.D. Department of Ophthalmology, The Catholic University, Gangnam St. Mary’s Hospital #505 Banpo-dong Seocho-gu, Seoul 137-701, Korea Tel: 82-2-590-1523, Fax: 82-2-590-2044, E-mail: ckpark@catholic.ac.kr

Received 2 May 2008 Accepted 20 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the ability of Heidelberg Retina Tomograph (HRT) 2 and the new version, HRT3, to discriminate between glaucoma and non-glaucoma eyes and to evaluate the most useful parameters for glaucoma detection.

Methods

Fifty-two healthy eyes, 62 glaucoma-suspect eyes, and 172 glaucoma eyes (a total of 286 eyes) were studied retrospectively. The discrimination capabilities of healthy and glaucomatous eyes were compared using areas under the receiver operating characteristics (AROCs) curves. Agreement between classifications was defined by κ analysis.

Results

The stereometric parameters that best discriminated between glaucoma and non-glaucoma eyes were cup shape measure at HRT2 (areas under the ROCs curves (AUC) 0.784) and global probability score (GPS) at HRT3 (AUC 0.718). The stereometric parameters that best discriminated between normal and non-normal eyes were cup shape measure at HRT2 (AUC 0.785) and GPS at HRT3 (AUC 0.696). The sensitivity was 95% at HRT3 and 91% at HRT2, and specificity was 61% at HRT2 and 59% at HRT3.

Conclusions

The glaucoma-discriminating ability of the HRT3 software is similar to that of HRT2; however, HRT3 provided results without the need for subjective operator input.

Keywords: HRT, Glaucoma

References

1. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol. 1996; 80:389–93.

2. Kruse FE, Burk RO, Volcker HE. . Reproducibility of topographic measurements of the optic nerve head with laser tomographic scanning. Ophthalmology. 1989; 96:1320–4.

3. Dreher AW, Tse PC, Weinreb RN. Reproducibility of topographic measurements of the normal and glaucomatous optic nerve head with the laser tomographic scanner. Am J Ophthalmol. 1991; 111:221–9.

4. Rohrschneider K, Burk RO, Volcker HE. Reproducibility of topometric data acquisition in normal and glaucomatous optic nerve heads with the laser tomographic scanner. Graefes Arch Clin Exp Ophthalmol. 1993; 231:457–64.

5. Miqlior S, Casula M, Guareschi M. . Clinical ability of Heidelberg retinal tomograph examination to detect glauco matous visual field changes. Ophthalmology. 2001; 108:1621–7.

6. Uchida H, Brigatti L, Caprioli J. Detection of structural damage from glaucoma with confocal laser image analysis. Invest Ophthalmol Vis Sci. 1996; 37:2393–401.

7. Hatch WV, Flanagan JG, Etchells EE. . Laser scanning tomogrphy of the optic nerve head in ocular hypertension and glaucoma. Br J Ophthalmol. 1997; 104:545–8.

8. Miglior S, Albe E, Guareschi M. . Intraobserver and interobserver reproducibility in the evaulation of optic disc steremetric parameters by Heidelberg Retina Tomograph. Ophthalmology. 2002; 109:1072–7.

9. Garway-Heath DF, Poinoosawmy D, Wollstein G. . Interobserver and intraobserver variation in the analysis of optic disc images : comparision of the Heidelberg retina tomograph and computer assisted planimetry. Br J Ophthalmol. 1999; 83:664–9.

10. Iester M, Mikelberg FS, Courtright P. . Interobserver variability of optic disc variables measured by confocal scanning laser tomography. Am J Ophthalmol. 2001; 132:57–62.

11. Swindale NV, Stjepanovic G, Chin A, Mikelberg FS.Automated analysis of normal and glaucomatous optic nerve head topography images. Invest Ophthalmol Vis Sci. 2000; 41:1730–42.

12. Park YJ, Park CK, Moon JI, Baek NH. The Diagnostic Precision of Glaucoma Classification with New HRT Discriminant Formula in Koreans. J Korean Ophthalmol Soc. 1999; 40:175–81.

13. Sommer A, Pollack I, Maumence AE. Optic disc parameters and onset of glaucomatous field loss. Arch Ophthalmol. 1979; 97:1444–8.

14. Quigley HA, Addicks EM, Gree WR. Optic nerve damage in human glaucoma. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy. Arch Ophthalmol. 1982; 100:135–46.

15. Pederson JE, Anderson DR. The mode of progressive disc cupping in ocular hypertension and glaucoma. Arch Ophthalmol. 1980; 98:490–5.

16. Caprioli J, Miller JM, Sears M. Quantitative evaluation of the optic nerve head in patients with unilateral visual field loss from primary open angle glaucoma. Ophthalmology. 1987; 94:1484–7.

Figure 1.

Comparision of glaucoma and non-glaucoma eyes with HRT (Heidelberg Retina tomography) 2.

Figure 2.

Comparision of glaucoma and non-glaucoma eyes with HRT (Heidelberg Retina Tomograph) 3.* GPS=Global probability score.

Figure 3.

Comparision of normal and non-normal eyes with HRT (Heidelberg Retina Tomograph) 2.

Figure 4.

Comparision of normal and non-normal eyes with HRT (Heidelberg Retina Tomograph) 3.* GPS=Global probability score

Table 1.

Characteristics of the study population

	Normal Glaucoma suspect	Glaucoma
	(n=52)(n=62)	(n=172)
Age (yrs)	44.7±12.846.5±14.0	48.7±15.4
Mean deviation (dB)	-1.8±1.1-1.7±1.2	-9.9±6.4
Pattern deviation (dB)	1.7±0.31.7±0.4	4.8±3.7

Table 2.

Subjects' Classification by Overall Heidelberg Retina Tomograph (HRT) 2 and HRT (Heidelberg Retina Tomograph) 3

		HRT3
HRT2	WNL	BL	ONL	TOTA L
WNL*	20	19	16	55
BL^†	10	17	27	54
ONL^‡	4	29	144	177
TOTAL	34	65	187	286

HRT Heidelberg Retina Tomograph;

^* WNL=within normal limits;

^† BL=borderline;

^‡ ONL=outside normal limits.

Table 3.

Sensitivity, Specificiy for discrimination between Normal vs Glaucoma with HRT (Heidelberg Retina Tomograph)2, HRT (Heidelberg Retina Tomograph) 3

	Sensitivity	Specificity
HRT2	91%	61%
HRT3	95%	59%

TOOLS

Similar articles