EVALUATION OF "THE NUMBER" OBTAINED FROM NERVE FIBER ANALYZER (GDX)

M. Osako, K. Yamada, K. Tachibana, T.  Okano and M. Usui

Department of Ophthalmology, Kasumigaura Hospital, Tokyo Medical University, Japan

"The Number" is one of the Nerve Fiber Analyzer (GDx) parameters, which uses trained neural network to consider more than 200 parameters obtained when the image is acquired.  The Number is currently under evaluation, but provisionally the ranges of 0-30, 31-70 and 71-100 are determined to be normal, glaucoma suspect, and glaucoma, respectively.  In this study, we investigated the clinical effectiveness of the Number.  Twenty-five eyes of 25 normal persons, 9 eyes of 9 ocular hypertensive patients (OHT) and 42 eyes of 42 glaucoma patients were studied.  Three consecutive GDx images were averaged to obtain a mean image. The 24-2 Program of the Humphrey Field Analyzer (HFA) was also performed on each subject.  All glaucoma patients had either an abnormal glaucoma hemifield test or one of the visual field indices (MD, CPSD) below the 5% probability level.  The average values of the Number were 36.6±}20.4 in normal group, 42.6±}23.1 in OHT group, and 67.4±}19.2 in glaucoma group, and significant differences were found between normal and glaucoma groups, and between OHT and glaucoma groups (p<.01).  Forty-eight percent of normal group and 50% of glaucoma group were in the Number range of 31-70 and were therefore classified as glaucoma suspects.  Using a Number cutoff of 50, the sensitivities were 81%, 71%, and 88% for all, early, and moderate or advanced glaucoma patients, respectively, with a specificity of 80%.  Conclusions: The Number was the most promising parameter for diagnosing glaucoma.