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1 From the Glaucoma Center, Department of Ophthalmology and 2 Department of Family and Preventive Medicine, University of California San Diego, La Jolla.
PURPOSE. To compare the abilities of scanning laser polarimetry (SLP), optical coherence tomography (OCT), short-wavelength automated perimetry (SWAP), and frequency-doubling technology (FDT) perimetry to discriminate between healthy eyes and those with early glaucoma, classified based on standard automated perimetry (SAP) and optic disc appearance. To determine the agreement among instruments for classifying eyes as glaucomatous.
METHODS. One eye of each of 94 subjects was included. Healthy eyes (n = 38) had both normal-appearing optic discs and normal SAP results. Glaucoma by SAP (n = 42) required a repeatable abnormal result (glaucoma hemifield test [GHT] or corrected pattern standard deviation [CPSD] outside normal limits). Glaucoma by disc appearance (n = 51) was based on masked stereoscopic photograph evaluation. Receiver operating characteristic (ROC) curve areas, sensitivities, and specificities were calculated for each instrument separately for each diagnosis.
RESULTS. The largest area under the ROC curve was found for OCT inferior
quadrant thickness (0.91 for diagnosis based on SAP, 0.89 for diagnosis
based on disc appearance), followed by the FDT number of total
deviation plot points of 
5% (0.88 and 0.87, respectively), SLP
linear discriminant function (0.79 and 0.81, respectively), and SWAP
PSD (0.78 and 0.76, respectively). For diagnosis based on SAP, the ROC
curve area was significantly larger for OCT than for SLP and SWAP. For
diagnosis based on disc appearance, the ROC curve area was
significantly larger for OCT than for SWAP. For both diagnostic
criteria, at specificities of 
90% and 70%, the most sensitive OCT
parameter was more sensitive than the most sensitive SWAP and SLP
parameters. For diagnosis based on SAP, the most sensitive FDT
parameter was more sensitive than the most sensitive SLP parameter at
specificities of 90% and 70% and was more sensitive than the most
sensitive SWAP parameter at specificity of 70%. For diagnosis based
on disc appearance at specificity of 90%, the most sensitive FDT
parameter was more sensitive than the most sensitive SWAP and SLP
parameters. At specificity 90%, agreement among instruments for
classifying eyes as glaucomatous was poor.
CONCLUSIONS. In general, areas under the ROC curve were largest (although not always significantly so) for OCT parameters, followed by FDT, SLP, and SWAP, regardless of the definition of glaucoma used. The most sensitive OCT and FDT parameters tended to be more sensitive than the most sensitive SWAP and SLP parameters at the specificities investigated, regardless of diagnostic criteria.
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