Significance of the disc damage likelihood scale objectively measured by a non-mydriatic fundus camera in preperimetric glaucoma

Milena Pahlitzsch,¹ Necip Torun,¹ Carl Erb,² Jeanette Bruenner,¹ Anna Karina B Maier,¹ Johannes Gonnermann,¹ Eckart Bertelmann,¹ Matthias K J Klamann<sup>1

1</sup>Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, ²Augenklinik am Wittenbergplatz, Berlin, Germany

Purpose: To assess the correlation between the disc damage likelihood scale (DDLS) objectively measured by a non-mydriatic fundus camera, Heidelberg Retina Tomograph 3, and optic coherence tomography in preperimetric glaucoma.
Methods: One-hundred-twenty-five patients with preperimetric primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (n=30) were included (mean age 58.9±15.9 years). All three devices graded the optic disc topography: Diagnosis 1 was defined as “outside normal limits”, while Diagnosis 2 as “borderline or outside normal limits”.
Results: For Diagnosis 1, a significant correlation was shown between DDLS and Moorfields regression analysis (P=0.022), and for Diagnosis 2 with glaucoma probability score analysis (P=0.024), in POAG. In pseudoexfoliation glaucoma, DDLS did not correlate significantly with Heidelberg Retina Tomograph 3 and optic coherence tomography. Regarding the area under the curve the highest predictive power was demonstrated by the objective DDLS (0.513–0.824) compared to Burk (0.239–0.343) and Mikelberg (0.093–0.270) coefficients.
Conclusions: The DDLS showed a significant correlation to the Moorfields regression analysis in preperimetric POAG. The objective DDLS showed the highest predictive power and thus is an additive tool in diagnosing preperimetric glaucoma.

Keywords: DDLS, preperimetric glaucoma, optic coherence tomography, stereophotography, Heidelberg Retina Tomograph