Evaluation of the Different Methods of Optic Disc Examination in Glaucomatous Patients

Abstract Background Glaucoma is the second leading cause of irreversible blindness worldwide. It affects the nerve fiber layer which forms the optic nerve. Many patients discover glaucoma accidently when they’re doing regular checkups. Glaucoma may have no specific symptoms until the advanced stages and it can be diagnosed by measuring intra ocular pressure, optic disc evaluation and visual field examination. The present work aims at evaluation of different methods in optic disc examination in glaucoma patients to detect their efficacy in diagnosis and follow up. Purpose To evaluate the agreement among slit lamp biomicroscopy, stereoscopic fundus photography and OCT in glaucomatous patients regarding Disc area, Cup area and vertical cup disc ratio (VCDR). Material and Methods 14 known glaucomatous patients were included in this cross-sectional observational descriptive. All patients under went slit lamp biomicroscopy examination by using +90 lens, stereoscopic fundus photography to obtain 3D image for optic disc and using computerized program to measure the optic disc parameters and Optical Coherence Tomography for the optic disc. Results Comparing each examiner values measured on stereoscopic fundus image in comparison with OCT. Examiner one have a moderate reliability regarding disc area, cup area and VCDR with ICC 0.67, 0.67 and 0.50 and P values 0.68, 0.61 and 0.01 respectively and examiner two have a moderate reliability regarding disc area, cup area and VCDR with ICC 0.66, 0.63 and 0.54 and P values 0.16, 0.69 and 0.03 respectively and examiner 3 has a moderate reliability regarding disc area and VCDR with ICC 0.65, 0.71 and P value 0.69, 0.07 respectively while a good reliability for cup area with ICC 0.82 and P value 0.02. Comparing values obtained by slit lamp using +90 lens and stereoscopic fundus photography regarding VCDR there is a moderate reliability with ICC 0.50 and P value 0.06 for examiner one only. Conclusion The results of the present study showed that there is an moderate agreement between stereoscopic fundus photography and OCT and slit lamp values regarding disc area, cup area and CD ratio.