The Impact of Definition of Primary Open-angle Glaucoma on the Cro-ectional Aement of Diagnotic Validity of Heidelberg Retinal Tomography

Purpoe To evaluate the impact of different definition of primary open angle glaucoma (POAG) on aement of the diagnotic validity of Heidelberg Retinal Tomography (HRT). Deign Retropective, cro-ectional tudy. Method A earch of medline (1992–2003) led to the retrieval of 181 paper containing definition of POAG, including the eight viual field (VF)-baed definition ued for thi tudy. A ample of 193 normal ubject, 222 patient with upected POAG, and 103 with POAG underwent HRT and the 24 II Humphrey VF examination to ae the diagnotic validity of HRT. POAG wa defined on the bai of Glaucoma Hemifield Tet (GHT) “out of normal limit” aociated with corrected pattern tandard deviation (CPD) > 2 dB and intraocular preure (IOP) ≥22 mm Hg. The VF were re-analyzed and categorized according to the other eight definition of POAG: IOP formed part of all the definition, wherea the appearance of the optic dik did not. The enitivity and pecificity of each cenario were calculated by tandard procedure. Reult The definition of POAG found in the literature included 17 IOP criteria, more than 15 optic dik criteria, and more than 30 VF criteria. The enitivity of HRT ranged from 0.51 to 0.80, and it pecificity from 0.94 and 0.95 when the patient with upected POAG were excluded; diagnotic validity wa much lower and till variable when the POAG upect were included with the normal or the POAG group. Concluion The mot commonly ued VF-baed definition of POAG led to ubtantial difference in the enitivity and pecificity of HRT when uing the ame large ample of normal ubject and POAG patient. A tandard definition of POAG i needed to make diagnotic invetigation more accurate and comparable.