TY  - JOUR
T1  - UNderstanding disparities among diagnostic technologies in glaucoma
AU  - De Moraes CV, Liebmann JM, Ritch R, Hood DC
Y1  - 2012/07/01
N1  - 10.1001/archophthalmol.2012.786
JO  - Archives of Ophthalmology
SP  - 833
EP  - 840
VL  - 130
IS  - 7
N2  - Objective 
                  To investigate causes of disagreement among 3 glaucoma diagnostic techniques: standard automated achromatic perimetry (SAP), the multifocal visual evoked potential technique (mfVEP), and optical coherence tomography (OCT).Methods 
                  In a prospective cross-sectional study, 138 eyes of 69 patients with glaucomatous optic neuropathy were tested using SAP, the mfVEP, and OCT. Eyes with the worse and better mean deviations (MDs) were analyzed separately. If the results of 2 tests were consistent for the presence of an abnormality in the same topographic site, that abnormality was considered a true glaucoma defect. If a third test missed that abnormality (false-negative result), the reasons for disparity were investigated.Results 
                  Eyes with worse MD (mean [SD], −6.8 [8.0] dB) had better agreements among tests than did eyes with better MD (−2.5 [3.5] dB, P < .01). For the 94 of 138 hemifields with abnormalities of the more advanced eyes, the 3 tests were consistent in showing the same hemifield abnormality in 50 hemifields (53%), and at least 2 tests were abnormal in 65 of the 94 hemifields (69%). The potential explanations for the false-negative results fell into 2 general categories: inherent limitations of each technique to detect distinct features of glaucoma and individual variability and the distribution of normative values used to define statistically significant abnormalities.Conclusions 
                  All the cases of disparity could be explained by known limitations of each technique and interindividual variability, suggesting that the agreement among diagnostic tests may be better than summary statistics suggest and that disagreements between tests do not indicate discordance in the structure-function relationship.
SN  - 0003-9950
M3  - doi: 10.1001/archophthalmol.2012.786
UR  - http://dx.doi.org/10.1001/archophthalmol.2012.786
ER  -