Die ‚Cup-to-Disk Ratio’: Ein Vergleich von TopSS, HRT II und subjektiver Befundung

Autor: G. Grabner, K. Hornykewycz, Wolfgang Hitzl, Herbert A. Reitsamer
Rok vydání: 2007
Předmět:
Zdroj: Klinische Monatsblätter für Augenheilkunde. 224:391-395
ISSN: 1439-3999
0023-2165
DOI: 10.1055/s-2007-963092
Popis: PURPOSE: One of the major shortcomings of longitudinal studies is the fact that instruments and technologies which were used at the beginning of the sampling might be replaced by others during the course of the study. The aim of the present work is to evaluate the relationship of optic disk parameters assessed with different methods and to test statistical possibilities of transforming these parameters into each other. PATIENTS AND METHODS: The ‘cup-to-disc ratio’, the ‘total disc area’ and the ‘neuroretinal rim area’ of the human optic nerve of 131 eyes of 66 patients participating in the Salzburg-Moorfields Collaborative Glaucoma Study were assessed with two different laser scanning methods (TopSS® and HRT II®). The ‘cup-to-disc ratio’ was also determined subjectively by ophthalmologists of the glaucoma department. To compare the three data sets, the method of Bland-Altman, paired t-tests, as well as regression analyses were applied. RESULTS: The ‘cup-to-disc ratios’ were: HRT II®: 0.26 (95 % CI: 0.23 - 0.28), subjective assessment of ‘cup-to-disc ratio’: 0.33 (0.30 - 0.36) and TopSS®: 0.43 (0.40 - 0.46). All three results are statistically significantly different (pairwise comparisons, p < 0.00001 each). Bland-Altman analysis shows that the differences of both objective methods exceed a magnitude that can be accepted for clinical purposes. The regression analyses reveal that the slope parameters are significantly different from 1.0. No regression models could be found with sufficiently small differences. DISCUSSION: There are significant differences in the ‘cup-to-disc Ratios’ observed between the three methods. Therefore the application of a ‘correction factor’ cannot be advocated. Although such factors allow the means of the samples to agree, the differences of individual measurements still remain too large, to be useful for practical purposes.
Databáze: OpenAIRE