The Research Of Diagnostic Statistics In Optical Coherence Tomography To Distinguish Early Glaucoma

Objective and Significance: The research applied many kind of evaluation index and statistical analysis model to investigate the ability of Optical Coherence Tomography (OCT) to distinguish early glaucoma and to propose some highly efficient indices to diagnose glaucoma earlier. The method of diagnostic statistics were Bayes decision theorys,ROC curve,areas under ROC curve,meta-analysis and SROC etc.Materials and Methods: (1) Prospective, non-randomized, cross-sectional study;(2) eyes of early chronic glaucoma(n=119),eyes of consecutive normal(n=122) and eyes of confused normal(n=148) were enrolled and completed routine ophthalmic examination, OCT RNFL3.4, Humphrey 24-2 threshold, fundus examination, IOP measurement and gonioscope examination within 1 day; (3)To define the positive diagnostic standards and grading levels of OCT by OCT own data-base (4)Studied indices: sensitivity, specificity, accuracy, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and the initial 27 indices of OCT; (5)All data were evaluated with SPSS 11.0 for Windows and Revman 4.2 and meta test vision 0.6.Results:In the Meta analysis,we found the reports of fielded POAG's sensitivity of OCT ranged from 0.81 to 0.96, and specificity from 0.90 to 0.96. The pooled weighted sensitivity and specificity for OCT with 95% confidence intervals(95%CI) after correction for standard error were 0.87 (0.83-0.90), 0.93 (0.90-0.95), respectively the AUC of SROC was 0.9671. The reported of early POAG's sensitivity and specificity of OCT were 0.74(95%CI 0.66-0.81),0.86(95%CI 0.78 -0.91).The AUC of SROC was 0.8166. Sensitivity analysis demonstrated no disproportionate influences of individual study.In the diagnostic experiment,The sensitivity of OCT was 74.5% and specificity was 82.8%. The best parameters in ROC Curve in the early diagnosis of primary open- angle glaucoma (POAG) was a criterion of >or=1 clock hours abnormal at the <5% level. The 9...