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

Authors Pahlitzsch M, Torun N, Erb C, Bruenner J, Maier A, Gonnermann J, Bertelmann E, Klamann M

Received 27 July 2015

Accepted for publication 31 August 2015

Published 20 November 2015 Volume 2015:9 Pages 2147—2158

DOI https://doi.org/10.2147/OPTH.S93213

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cem Ozgonul

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


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 Klamann1

1Department 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

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