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AimTo compare the performance of Heidelberg retina tomograph (HRT) and scanning laser polarimetry (GDx) with photographic evaluation of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) in the application of the Finnish Evidence-Based Guideline for Open-Angle Glaucoma.MethodsA total of 41 control participants and 312 patients referred for glaucoma evaluation were included in the study. All the participants underwent ophthalmic evaluation, ONH stereophotography, monochromatic RNFL photography, HRT, optical coherence tomography, and GDx evaluation. Participants were classified on the basis of stereophotographic or imaging device results based by applying the Finnish Guideline.ResultsAgreement between the stereophotographic evaluation and that on the basis of the imaging devices was 52.9%. Classification of patients with similar management advice on the basis of these evaluations had 56.4% agreement. The specificity of the Finnish guideline for detecting normal patients was 78% (stereophotography) and 83% (imaging devices). Optic disc size interfered with the diagnosis in patients evaluated using the HRT3 glaucoma probability score. Structural changes were more frequently detected before functional changes.ConclusionThe Finnish Evidence-Based Guideline for Open-Angle Glaucoma is useful for classifying normal participants and patients with suspected glaucoma or glaucoma through either conventional stereophotographic evaluation of the neuroretinal structures or with the new imaging devices. [ABSTRACT FROM AUTHOR]

Purpose To calculate and validate a linear discriminant function (LDF) for scanning laser polarimetry (SLP) with variable corneal compensation (GDx-VCC) to increase the diagnostic accuracy when using isolated retinal nerve fibre layer (RNFL) parameters to discriminate between healthy and glaucomatous eyes with visual field loss.Methods We prospectively selected two independent samples (teaching and validating sets). The teaching set, comprising 71 consecutive healthy subjects and 73 patients with open-angle glaucoma, was used to calculate the LDF. The validating set, comprising 72 consecutive normal eyes and 76 glaucoma patients, was used to test the performance of the LDF in an independent population. Receiver operating characteristic (ROC) curves were plotted for the validating set to evaluate the diagnostic accuracy of the LDF and the SLP parameters.Results The obtained function was LDF=−12.20+(0.15 × nasal average)−(23.85 × normalized inferior area)+(1.18 × maximum modulation). The areas under the ROC curve were 0.901 and 0.893 for our LDF and 0.893 and 0.877 for the nerve fibre indicator (NFI) in the teaching and validating populations, respectively. There were no significant differences between these values (P=0.743 in the teaching set, and P=0.458 in the validating set). NFI was the SLP-provided parameter with the best sensitivity–specificity balance. Sensitivities were 57.89% for the LDF and 48.68% for NFI at 95% fixed specificity.Conclusions The LDF and NFI were the most accurate SLP parameters for diagnosing glaucoma. The LDF yielded the highest sensitivity at 95% fixed specificity to discriminate between normal and glaucoma subjects.Eye (2009) 23, 593–600; doi:10.1038/eye.2008.50; published online 29 February 2008 [ABSTRACT FROM AUTHOR]

ABSTRACT. Purpose: To compare the effects on intraocular pressure (IOP) of latanoprost 0.005% and the fixed combination of dorzolamide 2% and timolol 0.5%. Methods: Overall, 226 patients whose IOP was insufficiently controlled by timolol alone were randomized to receive either latanoprost once daily or the fixed combination of dorzolamide plus timolol twice daily. Intraocular pressure was measured at 10 : 00 am and 5 : 00 pm at baseline and after 3 months of treatment. Results: Mean IOP was reduced from baseline in both groups (p < 0.001), with a mean ± SEM reduction of - 4.3 ± 0.3 mmHg (19%) for the latanoprost treatment group and - 4.0 ± 0.3 mmHg (17%) for the dorzolamide plus timolol treatment group. The two therapies were similarly effective in lowering IOP levels (mean difference in reduction: - 0.4 ± 0.4; 95% confidence interval: - 1.1, 0.4). Conclusions: Monotherapy with latanoprost once daily was as effective in reducing mean IOP as the fixed combination of dorzolamide plus timolol twice daily in patients with IOP insufficiently controlled by timolol alone. [ABSTRACT FROM AUTHOR]