@article{8fe0028e57b2441bb0f6a701ead1920e,
title = "Diagnostic accuracy of optical coherence tomography for diagnosing glaucoma: Secondary analyses of the GATE study",
abstract = "Background/Aims To assess the diagnostic performance of retinal nerve fibre layer (RNFL) data of optical coherence tomography (OCT) for detecting glaucoma. Methods Secondary analyses of a prospective, multicentre diagnostic study (Glaucoma Automated Tests Evaluation (GATE)) referred to hospital eye services in the UK were conducted. We included data from 899 of 966 participants referred to hospital eye services with suspected glaucoma or ocular hypertension. We used both eyes' data and logistic regression-based receiver operator characteristics analysis to build a set of models to measure the sensitivity and specificity of the average and inferior quadrant RNFL thickness data of OCT. The reference standard was expert clinician examination including automated perimetry. The main outcome measures were sensitivity at 0.95 specificity and specificity at 0.95 sensitivity and the corresponding RNFL thickness thresholds. We explored the possibility of accuracy improvement by adding measures of within-eye and between-eye variation, scan quality, intraocular pressure (IOP) and age. Results Glaucoma was diagnosed in at least one eye in 17% of participants. Areas under the curve were between 0.83 and 0.88. When specificity was fixed at 0.95, the sensitivity was between 0.38 and 0.55, and the highest values were reached with models including the inferior quadrant rather than the average RNFL thickness. Fixing sensitivity at 0.95, the specificity was between 0.36 and 0.58. The addition of age, refractive error, IOP or within-subject variation did not improve the accuracy. Conclusion RNFL thickness data of OCT can be used as a diagnostic test, but accuracy estimates remain moderate even in exploratory multivariable modelling of aiming to improve accuracy. {\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.",
keywords = "diagnostic tests/investigation, glaucoma, imaging, adult, age, Article, diagnostic accuracy, diagnostic test accuracy study, female, human, intraocular hypertension, intraocular pressure, major clinical study, male, multicenter study (topic), optical coherence tomography, priority journal, receiver operating characteristic, refraction error, retinal nerve fiber layer thickness, sensitivity and specificity",
author = "G. Virgili and M. Michelessi and J. Cook and C. Boachie and J. Burr and K. Banister and D.F. Garway-Heath and R.R.A. Bourne and {Asorey Garcia}, A. and C.R. Ramsay and A. Azuara-Blanco",
note = "Cited By :1 Export Date: 25 January 2019 CODEN: BJOPA Correspondence Address: Azuara-Blanco, A.; Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block A, Grosvenor Road, United Kingdom; email: a.azuara-blanco@qub.ac.uk Funding details: Health Technology Assessment Programme, HTA Funding details: National Institute for Health Research, NIHR Funding details: National Health Research Institutes, NHRI, 09/22/111 Funding details: Department of Health, DH Funding text 1: Acknowledgements The GATE study was funded by the National Institute of Health Research HTA programme (09/22/111). The views and opinions expressed are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health. References: Ferreras, A., Pablo, L.E., Pajar{\'i}n, A.B., Diagnostic ability of the heidelberg retina tomograph 3 for glaucoma (2008) Am J Ophthalmol, 145, pp. 354-359; Reus, N.J., Lemij, H.G., Diagnostic accuracy of the GDx VCC for glaucoma (2004) Ophthalmology, 111, pp. 1860-1865; Wu, H., De Boer, J.F., Chen, T.C., Diagnostic capability of spectral-domain optical coherence tomography for glaucoma (2012) Am J Ophthalmol, 153, pp. 815-826; Akashi, A., Kanamori, A., Nakamura, M., Comparative assessment for the ability of Cirrus, RTVue, and 3D-OCT to diagnose glaucoma (2013) Invest Ophthalmol Vis Sci, 54, pp. 4478-4484; Oddone, F., Centofanti, M., Tanga, L., Influence of disc size on optic nerve head versus retinal nerve fiber layer assessment for diagnosing glaucoma (2011) Ophthalmology, 118, pp. 1340-1347; Medeiros, F.A., Zangwill, L.M., Bowd, C., Comparison of the gdx vcc scanning laser polarimeter, hrt II confocal scanning laser ophthalmoscope, and stratus oct optical coherence tomograph for the detection of glaucoma (2004) Arch Ophthalmol, 122, pp. 827-837; Mwanza, J.C., Durbin, M.K., Budenz, D.L., Glaucoma diagnostic accuracy of ganglion cell-inner plexiform layer thickness: Comparison with nerve fiber layer and optic nerve head (2012) Ophthalmology, 119, pp. 1151-1158; De Le{\'o}n-Ortega, J.E., Sakata, L.M., Monheit, B.E., Comparison of diagnostic accuracy of heidelberg retina tomograph II and heidelberg retina tomograph 3 to discriminate glaucomatous and nonglaucomatous eyes (2007) Am J Ophthalmol, 144, pp. 525-532; Badal{\`a}, F., Nouri-Mahdavi, K., Raoof, D.A., Optic disk and nerve fiber layer imaging to detect glaucoma (2007) Am J Ophthalmol, 144, pp. 724-732; Michelessi, M., Lucenteforte, E., Oddone, F., Optic nerve head and fibre layer imaging for diagnosing glaucoma (2015) Cochrane Database Syst Rev, 11, p. CD008803; Azuara-Blanco, A., Banister, K., Boachie, C., Automated imaging technologies for the diagnosis of glaucoma: A comparative diagnostic study for the evaluation of the diagnostic accuracy, performance as triage tests and cost-effectiveness (GATE study) (2016) Health Technol Assess, 20, pp. 1-168; Banister, K., Boachie, C., Bourne, R., Can Automated Imaging for optic disc and retinal nerve fiber layer analysis aid glaucoma detection? (2016) Ophthalmology, 123, pp. 930-938; Pepe, M., Longton, G., Janes, H., Estimation and comparison of receiver operating characteristic curves (2009) Stata J, 9, p. 1; Dabasia, P.L., Fidalgo, B.R., Edgar, D.F., Diagnostic accuracy of technologies for glaucoma case-finding in a community setting (2015) Ophthalmology, 122, pp. 2407-2415; Katz, J., Quigley, H.A., Sommer, A., Detection of incident field loss using the glaucoma hemifield test (1996) Ophthalmology, 103, pp. 657-663; Levine, R.A., Demirel, S., Fan, J., Ocular hypertension treatment study group asymmetries and visual field summaries as predictors of glaucoma in the ocular hypertension treatment study (2006) Invest Ophthalmol Vis Sci, 47, pp. 3896-3903; Sackett, D.L., Straus, S.E., Richardson, W.S., (2000) Evidence-based Medicine. How to Practice and Teach EBM, , New York: Churchill Livingstone; Medeiros, F.A., Ng, D., Zangwill, L.M., The effects of study design and spectrum bias on the evaluation of diagnostic accuracy of confocal scanning laser ophthalmoscopy in glaucoma (2007) Invest Ophthalmol Vis Sci, 48, pp. 214-222; Rao, H.L., Kumbar, T., Addepalli, U.K., Effect of spectrum bias on the diagnostic accuracy of spectral-domain optical coherence tomography in glaucoma (2012) Invest Ophthalmol Vis Sci, 53, pp. 1058-1065",
year = "2018",
doi = "10.1136/bjophthalmol-2017-310642",
language = "English",
volume = "102",
pages = "604--610",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
publisher = "BMJ Publishing Group",
number = "5",
}