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Aim To assess the applicability of a structure-function (S-F) analysis combining spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP) in glaucoma screening in a middle-aged population. Methods A randomised sample of 3001 Caucasian participants aged 45-49 years of the Northern Finland Birth Cohort Eye Study was examined. We performed an eye examination, including 24-2 SAP, optic nerve head (ONH) and retinal nerve fibre layer (RNFL) photography and SD-OCT of the peripapillary RNFL. The S-F report was generated by Forum Glaucoma Workplace software. OCT, SAP and the S-F analysis were evaluated against clinical glaucoma diagnosis, that is, the positive '2 out of 3' rule based on the clinician's evaluation of ONH and RNFL photographs and visual fields (VFs). Results At a specificity of 97.5%, the sensitivity for glaucomatous damage was 26% for abnormal OCT, 35% for SAP and 44% for S-F analysis. Estimated areas under the curve were 0.74, 0.85 and 0.76, and the corresponding positive predictive values were 8 %, 10% and 12%, respectively. By applying a classification tree approach combining OCT, SAP and defect localisation data, a sensitivity of 77% was achieved at 90% specificity. In a localisation analysis of glaucomatous structural and functional defects, the correlation with glaucoma increased significantly if the abnormal VF test points were located on borderline or abnormal OCT zones. Conclusion SAP performs slightly better than OCT in glaucoma screening of middle-aged population. However, the diagnostic capability can be improved by S-F analysis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess and compare the optic nerve head (ONH) and retinal nerve fibre layer (RNFL) parameters and image quality parameters obtained by Cirrus HD‐OCT, GDxECC and HRT3 in a population‐based screening study. Methods: This analysis examined 2566 subjects taking part in the Northern Finland Birth Cohort Eye study. Images with spectral domain OCT (Cirrus HD‐OCT 4000), scanning laser ophthalmoscopy (HRT3) and scanning laser polarimetry (GDxECC) were obtained from each subject. The correlation of average and regional parameters of RNFL and ONH between devices was evaluated. Results: The RNFL thickness was 90.9 µm when measured with OCT, 24.6 µm with HRT and 48.1 µm with GDx. There was a high correlation between the disc and cup measurements with the HRT and OCT and the RNFL thickness of the OCT and GDx (r > 0.5). A statistically significant correlation was found between RNFL measurements of the HRT and OCT in the superior, temporal and inferior quadrants. Optical coherence tomography (OCT) signal strength correlated with the image quality parameters of the HRT and GDx. The percentage of good quality images was the lowest with the GDx. Conclusion: The RNFL thickness in Northern Finland birth cohort was at a lower level compared to other studies. The study confirms the difference in measuring ONH parameters between the imaging devices. However, significant correlations between devices were found in the cup volume and cup disc area ratio parameters of the OCT and HRT. The correlations between image quality parameters and glaucoma detection parameters were relatively low. [ABSTRACT FROM AUTHOR]

The optic nerve head (ONH) is a part of the brain that can be easily studied through the transparent medium of the eye. We explored the relationship between the properties of the optic nerve head, the retinal nerve fiber layer (RNFL) and cognitive function. Participants of the Northern Finland Birth Cohort (NFBC) 1966 underwent an ophthalmic and cognitive assessment after randomization at age 46. The ophthalmological parameters obtained were the disc area and the neuroretinal rim volume of the ONH and the average RNFL thickness. The surrogates used for cognitive function were the paired associates learning test (PAL), level of education, grade point average (GPA) and Humphrey 24–2 perimetric test time (HFA). We did exploratory research between the ophthalmological parameters and the surrogates for cognition and the correlations between the surrogates for cognition. We found that a larger disc area was associated with a higher level of education, faster accomplishment of the HFA (R = −0.065) but a lower GPA (R = −0.084). An increase in neuroretinal rim volume was associated with fewer errors in the PAL test (R = −0.056), higher level of education, higher GPA (R = 0.072) and faster accomplishment of the HFA (R = −0.047). A thicker RNFL was associated with faster accomplishment of the HFA (R = −0.047). We were able to find statistically significant associations between the parameters of the optic nerve head, the RNFL and cognition in the NFBC Eye study. However, the correlations were negligible at best and of limited predictive value. [ABSTRACT FROM AUTHOR]

Purpose: The evaluation of visual acuity (VA) and refraction in the Northern Finland Birth Cohort Eye study was performed using the Nidek AR‐360A autorefractometer. The accuracy of the method for this population‐based screening study was assessed. Methods: Measurements of the refractive error were obtained from the right eyes of 1238 subjects (mean age 47), first objectively with the AR‐360A and then subjectively by an optometrist. Agreement with the subjective refraction was calculated for sphere, cylinder, mean spherical equivalent (MSE), cylindrical vectors J45 and J0 and presbyopic correction (add). Visual acuity (VA) was measured using an ETDRS chart and the autorefractometer. Results: The refractive error measured with the AR‐360A was higher than the subjective refraction performed by the optometrist for sphere (0.007 D ± 0.24 D p = 0.30) and also for cylinder (−0.16 D ± 0.20 D p < 0.0005). The bias between the measurements of MSE, J45 and J0 was low: −0.07 D ± 0.22 D (p = 0.002), 0.01 D ± 0.43 D (p = 0.25) and −0.01 D ± 0.42 D (p = 0.43), respectively. The amount of add measured by the autorefractometer was higher than the subjective 0.35 D ± 0.29 D (p < 0.0005). There was a statistically significant correlation between VA (p < 0.0005) and the difference between the subjective and objective refraction. In 99.2% of the measurements, visual values were within one decimal line of each other. Conclusion: The Nidek AR‐360A autorefractometer is an accurate tool for determining the refraction and VA in a clinical screening trial. [ABSTRACT FROM AUTHOR]