Evaluación del disco óptico: el oftalmólogo joven, el experto y el HRT

Abstract

Objective: To compare the degree of agreement on the optic disc appearance between ophthalmologists with different levels of experience in glaucoma and confocal laser ophthalmoscopy (HRT). Materials and methods: Prospective observational clinical trial in patients attending the glaucoma service of a public hospital where two physicians (Evaluator A: a glaucoma specialist with 25 years of experience and Evaluator B: an ophthalmologist having an experience of 5 years) measured the largest and smallest diameter of the optic disc with a slit lamp and a 78 D double aspheric eye magnifier (on a dilated pupil) and calculated its area (by applying the formula for calculation of the area of an ellipse). Measurement was made subsequently with an HRT and results obtained by each physician were compared between each other and with those of the HRT. Differences were considered statistically significant at p < 0.05. Results: A total of 24 patients (48 eyes) were included. The area values obtained were as follows: evaluator A: 2.81 ± 0.06, evaluator B: 2.97 ± 0.12, HRT: 2.42 ± 0.06. Mean differences between all three groups were statistically significant (p= 0.0000012) while differences between both evaluators were not (p= 0.49). Conclusions: Subjective appreciation by physicians —both with a longer or shorter experience in glaucoma— overestimated optic disc area values vs HRT results. The actual clinical significance of this should be evaluated in future papers by using artificial intelligence and new algorithms for diagnosis and follow-up.