Diagnostic capabilities of frequency-doubling technology, scanning laser polarimetry, and nerve fiber layer photographs to distinguish glaucomatous damage

Am J Ophthalmol. 2001 Feb;131(2):188-97. doi: 10.1016/s0002-9394(00)00644-9.


Purpose: To investigate the ability of three diagnostic tests: frequency-doubling technology (FDT), scanning laser polarimetry (GDx), and nerve fiber layer (NFL) photographs to distinguish normal from glaucomatous eyes.

Methods: Data were obtained in a cross-sectional, hospital clinic-based study, including one eye from each of 253 persons older than 40 years (68 normal, 94 glaucoma suspects and 91 glaucoma patients). We performed a comprehensive ocular examination, as well as static automated perimetry (Humphrey 24-2), screening FDT, GDx, optic nerve stereoscopic photographs and high-contrast NFL photographs.

Results: The following were significantly different for glaucomatous patients compared with suspects and normals: mean values of mean deviation (MD, Humphrey 24-2) and corrected pattern standard deviation (CPSD), 11 GDx indices, mean FDT testing time and missed points, and NFL graded defects (ANOVA, Mantel-Haenszel test; p = 0.0001). Using Humphrey 24-2 test results and clinical assessment as the defining features of glaucoma, we found that the optimal mix of sensitivity and specificity values were 84% and 100% for FDT (presence of any defect); 62% and 96% for GDx (The Number, cut-off value of 27); and, 95% and 82% for NFL photographs (presence of any abnormality). FDT testing took the least time to be administered.

Conclusions: The FDT had the best diagnostic performance. Neural network analysis of GDx data outperformed other elements of its software.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Diagnostic Techniques, Ophthalmological*
  • Female
  • Glaucoma / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / pathology
  • Ocular Hypertension / diagnosis
  • Optic Disk / pathology
  • Photography / methods*
  • Reproducibility of Results
  • Retinal Ganglion Cells / pathology
  • Sensitivity and Specificity
  • Visual Field Tests