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Ko Eun Kim and Sohee Oh and Jin Wook Jeoung and Min Hee Suh and Je Hyun Seo and Martha Kim and Ki Ho Park and Dong Myung Kim and Seok Hwan Kim

期刊名称:American Journal of Ophthalmology




Purpose To investigate the additive role of spectral-domain optical coherence tomography (SDOCT) in the structural diagnosis in glaucoma. Design Reliability and validity analysis. Methods Structural examinations from 109 eyes of 109 healthy individuals and 151 eyes of 151 glaucoma patients with different severities were included. Four structural-diagnostic examination sets were prepared using stereo-optic disc photography (SDP), red-free retinal nerve fiber layer photography (RNFLP), and SDOCT: (1) SDP (S), (2) SDP and SDOCT (SO), (3) SDP and RNFLP (SR), and (4) SDP, RNFLP, and SDOCT (SRO). Five glaucoma specialists were instructed to classify subjects as normal or glaucoma using each of the 4 diagnostic sets in the order S, SO, SR, and SRO, with a 1-month interval. The interobserver agreement was evaluated using kappa (κ) statistics. The additive effect of SDOCT on the diagnostic performance of the specialists was evaluated using the generalized estimating equation. Results Five glaucoma specialists showed an excellent level of interobserver agreement on the diagnostic assessments based on the 4 sets. In the comparison of the collective diagnostic performance of the specialists, addition of SDOCT to SDP showed an approximately 2-fold significant increase in the diagnostic accuracy. Adding SDOCT to SDP significantly enhanced the specialists' structural-diagnostic ability with respect to the moderate glaucoma, though not mild or advanced glaucoma. Conclusions SDOCT significantly enhanced the diagnostic accuracy of the glaucoma specialists' performance, showing its additive diagnostic value in judging glaucomatous structural damage, especially in the moderate stage of glaucoma. "


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