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İstanbul Haydarpaşa Numune Hastanesi Purpose: To investigate the applicability of retinal nerve fiber layer photography (RNFLP) to our glaucoma department patients, the ratio of eligible photographs to grading and the correlation of the gradings with the clinical diagnosis.
Methods: RNFLP was done in 82 of 102 eyes with clear ocular media and good pupillary dilatation of a total of 51 patients, 19 of them had glaucoma, 19 ocular hypertension and 13 normal controls.The photographs were graded independantly by two observers using the same criteria and inter-observer agreement coefficient was calculated.The sensitivity, specificity, negative and positive diagnostic, value of RNFLP as a diagnostic procedure and correlation with clinical diagnosis was noted.
Results: The ratio of eligible photographs to grading was found to be 84.2 and 80.2% by two observers respectively and the coefficient of agreement was calculated to be 0.83.The sensitivity of RNFLP was 79%,specificity 91%,negative diagnostic value 81%,positive diagnostic value 89% in differentiating normal controls from patients with true glaucoma while the percentages were 55,91,62 and 88 respectively between normal controls and patients with ocular hypertension.The percentage of prediction of clinical diagnosis was calculated to be 55% when RNFLP was used as a single diagnostic test and 67% when combined with grading of optic nerve head cupping.
Conclusion: RNFLP was considered to be a reliable diagnostic procedure which was shown to be applicable to about 50% of our glaucoma department patients, yielding acceptable and gradable photographs and useful contribution to clinical diagnosis. Keywords : Retinal nerve fiber layer photography, interobserver agreement, correlation with clinical diagnosis