Comparison of 10-2 and 24-2 Perimetry toDiagnose Glaucoma Using OCT as anIndependent Reference Standard

摘要

Purpose: To compare the performance of the 10-2 test versus 24-2 standard automated perimetry (SAP) testfor the diagnosis of glaucoma using OCT as an independent standard for glaucomatous damage. Design: Cross-sectional study. Participants: A total of 1375 pairs of 10-2 and 24-2 SAP tests from 569 eyes of 339 subjects were used forthe analysis. A total of 440 (77%) eyes had a diagnosis of glaucoma, and 129 (23%) eyes were normal. Allparticipants underwent 10-2 and 24-2 SAP tests within 30 days. Methods: Glaucomatous severity was quantified based on OCT macula ganglion cell layer (mGCL) andcircumpapillary retinal nerve fiber layer. The area under the receiver operating characteristic (ROC) curve (AUC)was used to compare 10-2 and 24-2 metrics for discriminating healthy eyes from those of glaucoma, at differentlevels of disease severity. Main Outcome Measures: Areas under the ROC curves and sensitivities at fixed specificities of 80% and95%. Results: The overall AUC for mean deviation (MD) for the 24-2 test (0.808) was significantly higher than thatof the 10-2 test (0.742; P < 0.001). When compared at different stages of the disease, the 24-2 test performedgenerally better than the 10-2 test, notably in the earlier stages of the disease. For early damage (first quartile), the24-2 MD had an AUC of 0.658 versus 0.590 for 10-2 MD (P = 0.018). For advanced damage (fourth quartile),corresponding values were 0.954 vs. 0.903 (P = 0.013). Similar trends were observed when glaucoma severitywas defined based on structural macular damage with mGCL thickness. Conclusions: The 24-2 SAP test had better diagnostic accuracy compared with that of the 10-2 test fordetecting equivalent levels of glaucomatous damage, as measured by quantitative assessment of retinal nervefiber layer and macula by OCT. Financial Disclosure(s): Proprietary or commercial disclosure may be found after thereferences.