Journal of the Korean Ophthalmological Society 2005;46(5):810-820.
Published online May 31, 2005.
Diagnostic Ability of Qualitative Signs and Characteristics of Optic Disc in Angle-Closure Glaucoma and Open-Angle Glaucoma.
Jeong Hee Hwang, Ki Bang Uhm
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea. KBUhm@hanyang.ac.kr
폐쇄각녹내장과 개방각녹내장에서 시신경유두 정성적 소견들의 진단능력과 특성
황정희,엄기방
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
Correspondence:  Jeong-Hee Hwang, M.D.
Abstract
PURPOSE
To evaluate the ability of qualitative signs for glaucoma diagnosis, both alone and in combination, to discriminate between eyes with and without glaucomatous visual field damage. Furthermore, we investigated whether the characteristic optic disc changes in primary angle-closure glaucoma (PACG) differ from those in primary open-angle glaucoma (POAG). METHODS: Using color polaroid optic disc photographs, we examined 10 qualitative signs in 177 patients with PACG, 184 patients with POAG, and 181 normal subjects. RESULTS: Rim notches and rim shape alteration were found more frequently in patients with POAG than in those with PACG (p<0.05). Disc hemorrhage was not found in any eye in the PACG group. In the early stage (mean deviation >-6 dB) of the PACG and POAG groups, the best qualitative sign was rim shape alteration, and area under the receiver operating characteristic (ROC) curve was 0.696 and 0.768, respectively. The area under the ROC curve for the combination of qualitative signs was 0.802 and 0.918, respectively. CONCLUSIONS: These results suggest that glaucomatous disc damage was less pronounced in the PACG eyes than in the POAG eyes with similar visual field damage. A combination of the qualitative signs of optic disc using multiple logistic regression modelling improved the diagnostic ability.
Key Words: Glaucoma;Optic disc;Visual field


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