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. 2014 Dec 17;3(6):8.
doi: 10.1167/tvst.3.6.8. eCollection 2014 Oct.

Evaluation of a One-Page Report to Aid in Detecting Glaucomatous Damage

Donald C Hood  1 , Ali S Raza  2 , Carlos G De Moraes  3 , Paula A Alhadeff  4 , Juliet Idiga  3 , Dana M Blumberg  3 , Jeffrey M Liebmann  5 , Robert Ritch  4
Affiliations

Evaluation of a One-Page Report to Aid in Detecting Glaucomatous Damage

Donald C Hood et al. Transl Vis Sci Technol. .

Abstract

Purpose: We assessed the use of a customized, one-page structure + function report for aiding in detection of glaucomatous damage.

Methods: Two individuals (report specialists), experienced in analyzing optical coherent tomography (OCT) and visual field (VF) results, examined a customized one-page report for 50 eyes from 50 patients who either had glaucoma or were glaucoma suspects. The report contained key features of OCT scans with VF information. All patients had 24-2 VFs with a mean deviation (MD) better than -6 dB. The report specialists classified each hemifield and eye as either glaucomatous or nonglaucomatous based upon only the customized report, either without (phase 1) or with (phase 2) 24-2 VF information included on the report. Their results were compared to the classifications made by 3 ophthalmologists (glaucoma specialists) based upon traditional measures, namely stereo photographs, 24-2 VFs, and a commercially available, OCT disc scan report.

Results: The two report specialists agreed on all but one eye and four hemifields in phase 1, and on all eyes and all but one hemifield in phase 2. In phase 2, they judged 31 eyes abnormal. Of these 31 eyes, 30 were judged abnormal by all three glaucoma specialists and the 31st by two of the three. Without the VF information (phase 1), one report specialist classified 1, and the other 2, of these 31 "abnormal" eyes as normal.

Conclusions: When using the one-page report, the experienced readers showed excellent inter-rater repeatability and diagnostic ability relative to glaucoma specialists.

Translational relevance: This condensed report may help the clinician assess glaucomatous damage.

Keywords: glaucoma; optic disc; optical coherence tomography; retinal ganglion cell; visual fields.

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Figures

Figure 1.
Figure 1.
The one-page report used by the report specialists in phase 2. See text and the study of Hood and Raza for a description.
Figure 2.
Figure 2.
The same report as in Figure 1, but without the 24-2 visual field information.
Figure 3.
Figure 3.
An example of the information available to the glaucoma specialists during phase 1. Upper panel: disc fundus stereo photographs. Lower panel: 24-2 visual field report.
Figure 4.
Figure 4.
The commercial peripapillary circle scan added to the information the glaucoma specialist had in phase 2.
Figure 5.
Figure 5.
The white arrow indicates the hypodense region (“hole”) seen on the OCT scan of patient P6.
Figure 6.
Figure 6.
The report for patient P3 showing subtle OCT thinning (red arrows) and abnormal visual field locations (black arrow).
Figure 7.
Figure 7.
(A) The 24-2 total deviation and pattern deviation probability plots for the four eyes judged normal by one glaucoma specialist and the two report specialists, but abnormal by two of the glaucoma specialists. (B) The peripapillary RNFL thickness plots from our report for the same four eyes as in (A).
See this image and copyright information in PMC

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