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Clinical science
Exploring the gap between diagnostic research outputs and clinical use of OCT for diagnosing glaucoma
  1. Manuele Michelessi1,
  2. Luciano Quaranta2,
  3. Ivano Riva3,
  4. Enrico Martini4,
  5. Michele Figus5,
  6. Paolo Frezzotti6,
  7. Luca Agnifili7,
  8. Gianluca Manni1,8,
  9. Stefano Miglior9,
  10. Chiara Posarelli10,
  11. Stefano Fazio6,
  12. Francesco Oddone1
  1. 1IRCCS – Fondazione Bietti, Rome, Italy
  2. 2Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy
  3. 3Center for the Study of Glaucoma, University of Brescia, Brescia, Italy
  4. 4U.O. Ophthalmology, Sassuolo Hospital, Sassuolo, Italy
  5. 5Department of Neuroscience, University of Pisa, Pisa, Italy
  6. 6Department of Medicine, Surgery and Neuroscience, Ophthalmology Clinic, University of Siena, Siena, Italy
  7. 7Department of Medicine and Ageing Science, Ophthalmic Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
  8. 8DSCMT, University of Rome Tor Vergata, Rome, Italy
  9. 9Neuroscienze e Tecnologie Biomediche, Universita Bicocca, Milano, Basiglio, Milan, Italy
  10. 10Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Universita degli Studi di Pisa, Cisanello, Pisa, Italy
  1. Correspondence to Dr Francesco Oddone, Glaucoma, IRCCS Fondazione G.B.Bietti, Rome 00198, Italy; oddonef{at}gmail.com

Abstract

Aims To explore the gap between diagnostic research outputs and clinical use of optical coherence tomography (OCT) in glaucoma and assess the reliability of a specific reference database when applied to a morphological imaging parameter for diagnostic purposes.

Methods Consecutive subjects enrolled in the Multicenter Italian Glaucoma Imaging Study (MIGIS) have been included in this cross-sectional, comparative evaluation of diagnostic tests study. Patients underwent measurement of global and sectorial peripapillary retinal nerve fibre thickness (pRNFL) and minimum rim width (MRW) by OCT. The sensitivity and specificity of reference-database categorical classifications were calculated by means of 2×2 tables and sensitivity was compared with that of the corresponding continuous parameter extracted from the receiver operating characteristic (ROC) curves by matching the specificity.

Results 280 Caucasian subjects have been included. At matched specificities, the sensitivity of pRNFL categorical classifications was statistically similar to that of the corresponding continuous parameters, whereas the sensitivity of the MRW categorical classifications was significantly lower than that of the corresponding continuous parameters.

Conclusions The diagnostic accuracy of reference database classifications might be lower than that extrapolated from the ROC curves of continuous parameters used in diagnostic research. The gap between the accuracy of these two approaches may be used to estimate the reliability of a specific reference database when applied to a continuous parameter for diagnostic purposes.

  • glaucoma
  • diagnostic tests/Investigation
  • imaging
  • optic nerve

https://doi.org/10.1136/bjophthalmol-2019-314607

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    Footnotes

    • This paper was presented as a poster at the May 2019 ARVO meeting, Vancouver, Canada

    • Correction notice This article has been corrected since it was published Online First. Repeated content in Acknowledgement section has been removed.

    • Funding The contribution of the IRCCS Fondazione G.B. Bietti in this paper was supported by the Italian Ministry of Health and by Fondazione Roma.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon request.