Glaucoma probability score vs Moorfields classification in normal, ocular hypertensive, and glaucomatous eyes

Javier Moreno-Montañés, Alfonso Antón, Noelia García, Loreto Mendiluce, Eleonora Ayala, Angeles Sebastián
American Journal of Ophthalmology 2008, 145 (2): 360-368

PURPOSE: To evaluate the Heidelberg Retina Tomograph III (HRT III) glaucoma probability score in differentiating normal from pathologic eyes and to compare the glaucoma probability score with Moorfields regression analysis (MRA).

DESIGN: Prospective cross-sectional study.

METHODS: Fifty-nine normal, 40 hypertensive, and 83 glaucomatous eyes were examined with Swedish interactive threshold algorithm standard 24-2 visual fields and HRT III. Sensitivity and specificity were evaluated using global and sectorial glaucoma probability score and MRA compared with damage in visual fields. Areas under receiver operating characteristic (ROC) curves were evaluated. Agreement between MRA and glaucoma probability score was calculated using the kappa coefficient. Glaucoma probability score was considered to be displaced when a symbol was outside and the opposite symbol was inside the optic disk.

RESULTS: MRA sensitivity and specificity were 39.8% and 93.2% (most specific criteria) and 68.7% and 83.1% (least specific criteria), respectively. Glaucoma probability score sensitivity and specificity were 71.1% and 69.5% (most specific criteria) and 85.5% and 54.2% (least specific criteria), respectively. Visual field parameters were related to the global (P = .001) and sectorial (P < .05) glaucoma probability score. A displaced glaucoma probability score was found in 35 eyes, but with unchanged glaucoma probability score sensitivity and specificity. Areas under the ROC curves of glaucoma probability score was 0.77. The kappa coefficient was 0.34.

CONCLUSIONS: Glaucoma probability score analysis tends to be more sensitive but less specific than MRA. Glaucoma probability score did not differentiate normal and hypertensives eyes. When displaced, glaucoma probability score sensitivity and specificity were unchanged. MRA and glaucoma probability score agreement was low. Glaucoma probability score is advantageous over MRA in early-stage glaucoma.

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