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Biomedical subjects

Murray Fingeret

Publications and source records attributed to Murray Fingeret.

5 recordsLinked to original sources

Evaluation of decision rules for frequency-doubling technology screening tests.

PURPOSE: Frequency-doubling technology (FDT) perimetry has shown promise as a screening test for glaucoma. This study investigates different possible decision rules for FDT screening by applying them to groups of normal and glaucoma subjects. METHODS: Within three centers, 218 subjects (aged 15-88 years; 78 with glaucoma, 140 without ocular disease) were each tested twice with the screening program of the FDT perimeter. The subjects consisted of 140 normal subjects with no evidence of glaucoma or other ocular disease likely to affect the visual field and 78 subjects with a diagnosis of glaucoma and no other ocular disease. Fifteen decision rules were applied to the data to compare their sensitivity and specificity. RESULTS: Estimated specificities of the different decision rules ranged from 78% to 99%, although with this sample size, the confidence intervals for these estimates are quite large. Estimated sensitivities ranged from 40% to 72%. Suggested criteria for distinguishing normal subjects from those with glaucoma seem to be either a cluster of two or more adjacent locations abnormal at the p < 2% level with at least one location confirmed or a single location very abnormal (p < 1%) and confirmed. CONCLUSIONS: Specificity was clearly improved by confirming an apparently abnormal test result by repeating the screening test outweighing the resultant small loss in sensitivity. These findings provide useful information for making an informed choice of decision rules for FDT screening results.

Adolescent↗

Evaluation of screening versus regular polarimetry.

PURPOSE: The purpose of this study is to evaluate a new screening program for the GDx VCC (variable corneal compensation) retinal nerve fiber layer analyzer. This new method uses a fast screening approach to detect retinal nerve fiber layer loss associated with glaucoma. The study evaluates the sensitivity and specificity of the screening program and compares the results with those from the GDx VCC full examination. METHODS: One hundred seventeen eyes from 60 subjects with a mean age of 60.65 years (range, 41-79 years old) were analyzed. Subjects were divided into a normal or glaucoma group based on an ophthalmic examination. Each individual underwent a GDx VCC screening examination, GDx full examination, Humphrey HFA II 24-2 SITA Standard visual field, intraocular pressure assessment, and dilated optic nerve examination. The outcome for the GDx screening examination was within normal limits, borderline, or outside normal limits and compared with the GDx full examination results. RESULTS: The sensitivity and specificity for the GDx full examination were 73% and 79%, respectively. The sensitivity and specificity for the screening method were 67% and 91%, respectively. The full examination was more sensitive; however, the screening examination was more specific. CONCLUSION: The screening examination is more conservative than the full examination algorithm and may miss some individuals with glaucomatous damage that the full examination may identify. However, the number of false-positives for the screening examination is less than the full examination method.

Adult↗

Five rules to evaluate the optic disc and retinal nerve fiber layer for glaucoma.

A systematic approach for the examination of the optic disc and retinal nerve fiber layer is described that will aid in the detection of glaucoma. This approach encompasses 5 rules: evaluation of optic disc size, neuroretinal rim size and shape, retinal nerve fiber layer, presence of parapapillary atrophy, and presence of retinal or optic disc hemorrhages. A systematic process enhances the ability to detect glaucomatous damage as well as the detection of progression, and facilitates appropriate management.

Disease Progression↗

Characteristics of the normative database for the Humphrey matrix perimeter.

PURPOSE: The Humphrey Matrix (Carl Zeiss Meditec, Dublin CA; Welch-Allyn, Skaneateles, NY) is a high-spatial-resolution perimeter that uses frequency-doubling stimuli. It incorporates an efficient test strategy that assumes that age, eccentricity, and test procedure type have only small effects on sensitivity. The results used to create the normative database for the perimeter were examined, to see whether these assumptions were met and to examine the form of the normative data. METHOD: Visual fields were measured (Matrix 30-2, 24-2, 10-2 and Macula patterns) in >275 subjects judged to be normal by a battery of clinical procedures. The right eye was always tested first. RESULTS: Sensitivity decreased by approximately 0.7 dB per age decade across all eccentricities; sensitivity decreased with eccentricity, typically by <5 dB at the most peripheral points tested. Although there was no systematic difference in sensitivity between the 30-2 and 24-2 tests, the Macula test sensitivities were typically 1 dB higher than for the 10-2 test. Sensitivity in the left eye was slightly lower than in the right, with the difference being significantly greater in the temporal visual field. In most test locations, the 95% confidence interval of normal sensitivity was approximately 6 dB below the median sensitivity. CONCLUSIONS: The performance of the test strategy in the Matrix perimeter is appropriately matched to the response characteristics of the normal population. The finding of a spatially nonuniform difference in sensitivity between left and right eyes is attributable to light-adaptation differences between the eyes. This effect is accounted for in the perimeter's normative database.

Adolescent↗