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Glaucoma Detection with Frequency Doubling Perimetry (FDT) and Nerve Fibre Layer Analysis (GDx)

1Horn F. K., 1Nguyen N. X., 1Mardin C. Y., 1Jünemann A., 2Martus P., 1Korth M.,
1Friedrich-Alexander-Universität, Augenklinik (Erlangen)
2Freie Universität Berlin, Klinikum Benjamin Franklin, Institut für Medizinische Informatik, Biometrie und Epidemiologie (Berlin)

Purpose: Aim of this study was glaucoma detection in early and advanced open angle glaucomas (OAG) with two different glaucoma screening methods.
Method: 168 “perimetric” OAG eyes (glaucomatous optic disc atrophy and visual field defects, 104 patients), 115 “preperimetric” OAG eyes (glaucomatous optic disc atrophy, elevated introcular pressure, no visual field defects in conventional perimetry, 66 patients), and 132 healthy eyes of 79 control subjects. FDT screening with protocol C-20-5, polarimetry with GDx (“the_number”), conventional white-on-white perimetry and papillometry in all subjects. This study uses data-transfer- and statistic software (Viewfinder, SPSS) for casewise calculation of a “FDT-score” including all missed localized probability levels. Diagnostic value of procedures has been judged from the area under the ROC-curve. In addition to single parameters’ validity, the value of a discriminant function has been calculated for all individuals with the scores delivered by FDT and polarimetry: D= 0.036*fdt_score + 0.03 * GDx_number - 1.5.
Results: Area under ROC-curves for different tests and patient groups:
                                         FDT   GDX   D=f(FDT,GDx)
perimetric OAG:            0.94    0.88    0.96
preperimetric OAG:      0.67    0.73    0.77
In perimetric patients, area under ROC is significantly larger for FDT-score than for GDx-number. In the preperimetric group, however, ROC of the GDx-number is mostly above the FDT-score. A combination of both methods with a simple formula is superior to single tests in preperimetric as well as in perimetric patients.
Conclusions: The present study indicates that combination of different techniques, which can uncover different glaucoma properties can result in a improved validity of the procedures.
Supported by: DFG (SFB 539)