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Comparative Study
. 2008 May;49(5):1898-906.
doi: 10.1167/iovs.07-0111.

Comparison of HRT-3 glaucoma probability score and subjective stereophotograph assessment for prediction of progression in glaucoma

Luciana M Alencar  1 , Christopher Bowd, Robert N Weinreb, Linda M Zangwill, Pamela A Sample, Felipe A Medeiros
Affiliations
Comparative Study

Comparison of HRT-3 glaucoma probability score and subjective stereophotograph assessment for prediction of progression in glaucoma

Luciana M Alencar et al. Invest Ophthalmol Vis Sci. 2008 May.

Abstract

Purpose: To assess whether baseline Glaucoma Probability Score (GPS; HRT-3; Heidelberg Engineering, Dossenheim, Germany) results are predictive of progression in patients with suspected glaucoma. The GPS is a new feature of the confocal scanning laser ophthalmoscope that generates an operator-independent, three-dimensional model of the optic nerve head and gives a score for the probability that this model is consistent with glaucomatous damage.

Methods: The study included 223 patients with suspected glaucoma during an average follow-up of 63.3 months. Included subjects had a suspect optic disc appearance and/or elevated intraocular pressure, but normal visual fields. Conversion was defined as development of either repeatable abnormal visual fields or glaucomatous deterioration in the appearance of the optic disc during the study period. The association between baseline GPS and conversion was investigated by Cox regression models.

Results: Fifty-four (24.2%) eyes converted. In multivariate models, both higher values of GPS global and subjective stereophotograph assessment (larger cup-disc ratio and glaucomatous grading) were predictive of conversion: adjusted hazard ratios (95% CI): 1.31 (1.15-1.50) per 0.1 higher global GPS, 1.34 (1.12-1.62) per 0.1 higher CDR, and 2.34 (1.22-4.47) for abnormal grading, respectively. No significant differences (P > 0.05 for all comparisons) were found between the c-index values (equivalent to area under ROC curve) for the multivariate models (0.732, 0.705, and 0.699, respectively).

Conclusions: GPS values were predictive of conversion in our population of patients with suspected glaucoma. Further, they performed as well as subjective assessment of the optic disc. These results suggest that GPS could potentially replace stereophotograph as a tool for estimating the likelihood of conversion to glaucoma.

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Figures

Figure 1
Figure 1
Cumulative probability (Kaplan-Meier survival curve) of development of visual field loss or optic disc deterioration during the study.
FIGURE 2
FIGURE 2
Cumulative probability (Kaplan-Meier survival curve) of development of visual field loss or optic disc deterioration in patients with suspected glaucoma according to the baseline final classification of the GPS.
FIGURE 3
FIGURE 3
Cumulative probability (Kaplan-Meier survival curve) of development of visual field loss or optic disc deterioration in patients with suspected glaucoma according to the baseline grading of optic disc stereophotographs.
FIGURE 4
FIGURE 4
Venn diagram showing agreement between the GPS final classification and the stereophotograph grading at baseline for converters and nonconverters.
See this image and copyright information in PMC

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