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

Figures & data

Figure 1 Normogram of the disc damage likelihood scale.

Notes: The disc damage likelihood scale: a method of estimating the risk of glaucomatous damage of the optic nerve head. Figure courtesy of Kowa Company Ltd., Tokyo, Japan.

Table 1 Different glaucoma parameters in POAG and PEX glaucoma

	Preperimetric glaucoma	Mean	SD	SEM	P-value
CDR examiner	POAG	0.63	0.18	0.02
	PEX	0.55	0.20	0.04	0.046
GAT	POAG	15.17	2.99	0.29
	PEX	15.29	3.77	0.71	0.861
Perimetry MD	POAG	1.06	1.89	0.18
	PEX	1.22	1.64	0.30	0.669
Perimetry PSD	POAG	2.29	0.62	0.06
	PEX	2.03	1.14	0.21	0.242
Disc area HRT	POAG	2.21	0.46	0.05
	PEX	2.31	0.50	0.18	0.581
CDR HRT	POAG	0.39	0.16	0.02
	PEX	0.47	0.26	0.09	0.456
Rim-Disc-Area-Ratio HRT	POAG	0.61	0.16	0.02
	PEX	0.53	0.26	0.09	0.456
Cup volume HRT	POAG	0.26	0.20	0.02
	PEX	0.17	0.13	0.05	0.236
Vertical CDR HRT	POAG	0.61	0.15	0.02
	PEX	0.66	0.20	0.07	0.417
FSM	POAG	−0.22	2.18	0.25
	PEX	−0.32	1.96	0.69	0.904
RB	POAG	0.77	0.95	0.11
	PEX	−0.05	1.04	0.37	0.065
Disc area KOWA	POAG	2.80	0.55	0.05
	PEX	2.66	0.62	0.11	0.233
Cup volume KOWA	POAG	0.23	0.18	0.02
	PEX	0.12	0.12	0.02	<0.001
CDR vertical KOWA	POAG	0.56	0.15	0.01
	PEX	0.48	0.14	0.03	0.006
Cup-Disc-Area Ratio KOWA	POAG	0.33	0.15	0.01
	PEX	0.25	0.13	0.02	0.006
Rim-Disc-Area-Ratio KOWA	POAG	0.66	0.15	0.01
	PEX	0.75	0.13	0.02	0.006

Notes: Bold values indicate significant differences, P<0.05.

Abbreviations: CDR, cup/disc ratio; FSM, Mikelberg coeffiecient; HRT, Heidelberg Retina Tomograph; MD, mean deviation; PEX, pseudoexfoliation; POAG, primary open-angle glaucoma; PSD, pattern standard deviation; GAT, Goldmann applanation tonometry; RB, Burk coefficient; SD, standard deviation; SEM, standard error of mean.

Table 2 Correlation of the KOWA rim/disc ratio compared to RNFL, MRA, and GPS in the six quadrants of the optic nerve head in preperimetric POAG and PEX glaucoma

KOWA rim/disc ratio correlation coefficient, P-value	POAG			PEX glaucoma
	RNFL	MRA	GPS	RNFL	MRA	GPS
Temporal	r=0.144	r=0.294	r=−0.326	r=−0.021	r=0.207	r=0.378
	P=0.131	P=0.011	P=0.007	P=0.914	P=0.657	P=0.316
Superotemporal	r=0.260	r=0.285	r=−0.469	r=0.031	r=−0.434	r=−0.361
	P=0.006	P=0.014	P<0.001	P=0.873	P=0.330	P=0.340
Superonasal	r=0.412	r=0.192	r=−0.481	r=0.207	r=−0.599	r=−0.383
	P<0.001	P=0.101	P<0.001	P=0.282	P=0.155	P=0.310
Inferotemporal	r=0.171	r=−0.318	r=−0.460	r=−0.210	r=0.322	r=−0.127
	P=0.075	P=0.006	P<0.001	P=0.275	P=0.481	P=0.745
Inferonasal	r=0.363	r=0.199	r=−0.520	r=0.194	r=−0.694	r=−0.610
	P<0.001	P=0.089	P<0.001	P=0.312	P=0.084	P=0.081
Nasal	r=−0.313	r=0.133	r=−0.508	r=0.171	r=−0.680	r=−0.378
	P=0.001	P=0.258	P<0.001	P=0.376	P=0.093	P=0.316

Notes: Bold values indicate significant differences, P<0.05.

Abbreviations: GPS, glaucoma probability score; MRA, Moorfields regression analysis; PEX, pseudoexfoliation; POAG, primary open-angle glaucoma; RNFL, retinal nerve fiber layer.

Figure 2 Agreement of the disc damage likelihood scale compared to the Moorfields regression analysis, the glaucoma probability score of the HRT3, and RNFL of the SD-OCT related to Diagnosis 1 and Diagnosis 2 in primary open angle glaucoma.

Abbreviations: DDLS, disc damage likelihood scale; GPS, glaucoma probability scores; MRA, Moorfields regression analysis; OCT, optic coherence tomography; HRT3, Heidelberg Retina Tomograph 3; SD-OCT, spectral domain optic coherence tomography.

Figure 3 Agreement of the disc damage likelihood scale compared to the Moorfields regression analysis, the glaucoma probability score of the HRT3 and RNFL of the SD-OCT related to Diagnosis 1 and Diagnosis 2 in PEX glaucoma.

Abbreviations: DDLS, disc damage likelihood scale; GPS, glaucoma probability scores; MRA, Moorfields regression analysis; OCT, optic coherence tomography; HRT3, Heidelberg Retina Tomograph 3; SD-OCT, spectral domain optic coherence tomography.

Figure 4 ROC curves of the discriminant formulas.

Notes: Three ROC curves regarding Diagnosis 1: (A) Moorfields regression analysis, (B) OCT, and (C) glaucoma probability score for RB and FSM coefficients and DDLS (Blue = FSM, Green = RB, Yellow = DDLS, Purple = reference line).
Abbreviations: DDLS, disc damage likelihood scale; FSM, Mikelberg coeffiecient; OCT, optic coherence tomography; RB, Burk coefficient; ROC, receiving operator curve.

Figure 5 ROC curves of the discriminant formulas.

Notes: Three ROC curves regarding Diagnosis 2: (A) Moorfields regression analysis, (B) OCT, and (C) glaucoma probability score for RB and FSM coefficients and DDLS (Blue = FSM, Green = RB, Yellow = DDLS, Purple = Reference Line).
Abbreviations: DDLS, disc damage likelihood scale; FSM, Mikelberg coeffiecient; OCT, optic coherence tomography; RB, Burk coefficient; ROC, receiving operator curve.

Table 3 Value of area under the ROC curve, sensitivity, specifically for FSM, RB, DDLS considering Diagnosis 1 and 2 (MRA, GPS, OCT)

	Parameters	FSM	RB	DDLS
Diagnosis 1 MRA	Area ROC	0.134	0.252	0.599
	Standard error	0.039	0.055	0.066
	Sensitivity	0.833	0.833	1.000
	1 – specifity	1.000	1.000	0.921
Diagnosis 2 MRA	Area ROC	0.093	0.239	0.591
	Standard error	0.04	0.052	0.08
	Sensitivity	0.900	0.883	0.983
	1 – specifity	1.000	1.000	0.900
Diagnosis 1 GPS	Area ROC	0.266	0.343	0.513
	Standard error	0.06	0.065	0.07
	Sensitivity	0.872	0.872	0.972
	1 – specifity	1.000	0.966	0.966
Diagnosis 2 GPS	Area ROC	0.263	0.269	0.824
	Standard error	0.066	0.099	0.053
	Sensitivity	0.912	0.897	0.971
	1 – specifity	1.000	1.000	0.875
Diagnosis 1 OCT	Area ROC	0.256	0.307	0.520
	Standard error	0.076	0.07	0.073
	Sensitivity	0.714	0.714	0.952
	1 − specifity	1.000	1.000	0.966
Diagnosis 2 OCT	Area ROC	0.270	0.335	0.568
	Standard error	0.06	0.064	0.065
	Sensitivity	0.833	0.806	0.972
	1 – specifity	1.000	1.000	0.955

Abbreviations: DDLS, disc damage likelihood scale; FSM, Mikelberg coeffiecient; GPS, glaucoma probability score; MRA, Moorfields regression analysis; OCT, optic coherence tomography; RB, Burk coefficient; ROC, receiving operator curve.