The Value Of HRT-Ⅱ On Glaucoma-screening In Rural Population Of North China

Objective: 1. To measure optic nerve head topographic parameters by using the Heidelberg Retina Tomograph II (HRT-II) in the normal Chinese population. 2. To assess the accuracy of glaucoma-screening by using HRT-II in Chinese population.Methods: This project systematically involved all 13 village of Chinese population (aged 30 years or more) in Yougnian County, Handan city, Hebei province. All participants were undertook comprehensive screening eye examination, including visual acuity, standard slit lamp, intraocular pressure, HRT-II and stereoscopic optic disc photography. The global parameters of HRT-II were measured in normal population. ROC curves, sensitivity/specificity and likelihood ratios were calculated as the global parameters.Results: In this study, data from the first 11098 eyes of 5702 participants were selected. Of those, 4642 subjects (9284 eyes) were defined as normal and 151 subjects (283 eyes) were diagnosed as glaucoma. Reference ranges of linear cup/disc ratio, cup/disc area ratio and rim/disc area ratio were 0.042-0.658, 0.002-0.433, and 0.567-0.998, respectively. The difference in all parameters was statistically significant between the normal and glaucomatous subjects. The AUC and sensitivity/specificity for linear cup/disc ratio, cup/disc area ratio and rim/disc area ratio were 0.816 and 68.9%/79.7%, 0.815 and 65.4%/82.6%, 0.815 and 65.4%/82.6%, respectively. The better positive likelihood ratios of parameters were cup/disc area ratio (3.753) and rim/disc area ratio (3.753). The better negative likelihood ratios of parameters were cup area (0.288) and cup shape measure (0.317). Diagnostic accordance rate between qualitative index of HRT-II and specialist in glaucoma was poor, which was better between diagnostic standard of rim area based on our data and specialist in glaucoma.Conclusions: The accuracy of glaucoma-screening of global parameters of HRT-II was not ideal. However, the diagnostic accordance rate of rim area integrated with our data was better than other qualitative index of HRT-II. Therefore, HRT-II may provide more useful information to assist the clinician in diagnosing and screening of glaucoma, With the improvement of Chinese people database.