Discriminating Between Normal and Glaucomatous Eyes Using the Modified ISNT Rule. |
Myung Won Lee, Jong Hoon Shin, Chang Won Kee |
1Department of Ophthalmology, Dankook University School of Medicine, Cheonan, Korea. 2Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea. 3Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ckee@skku.edu |
새로운 시신경 테 너비의 규칙을 이용한 정상안과 녹내장안의 구별 |
이명원1⋅신종훈2⋅기창원3 |
Department of Ophthalmology, Dankook University School of Medicine1, Cheonan, Korea Department of Ophthalmology, Pusan National University School of Medicine2, Busan, Korea Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine3, Seoul, Korea |
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Abstract |
PURPOSE To evaluate the diagnostic ability of the modified ISNT rule (disc rim thickness of the smaller of inferior and superior > the larger of nasal and temporal) for normal and glaucomatous eyes compared to the classic ISNT rule (disc rim thickness of inferior > superior > nasal > temporal). METHODS: Color stereo optic disc photographs of 113 normal subjects and 108 open angle glaucoma patients with early and moderate stage were morphometrically evaluated. The classic ISNT rule and the modified ISNT rule were assessed by masked evaluation of disc photographs at the 3, 6, 9 and 12 o'clock positions. RESULTS: Among normal subjects, 58 of 113 eyes (51.3%) were normal and in open angle glaucoma patients, 104 of 108 eyes (96.3%) were abnormal with the classic ISNT rule. Among normal subjects, 98 of 113 eyes (94.2%) were normal and in open angle glaucoma patients, 102 of 108 eyes (94.4%) were abnormal with the modified ISNT rule. The modified ISNT rule was more accurate than the classic ISNT rule in terms of Cohen's Kappa analysis used for discriminating between normal and glaucomatous eyes. CONCLUSIONS: The modified ISNT rule is useful for differentiating between normal and glaucomatous optic nerves and easily applied in clinical practice. |
Key Words:
ISNT rule;Neuroretinal rim;Optic cup;Optic disc;Stereoscopic disc photography |
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