Sabeen Chaudhry, Mustafa Abdul Hameed Ismail.
Cup Disc Ratio: Agreement between Fundus Biomicroscopic estimation and Heidelberg Retinal Tomograph.
Al-Shifa J Ophthalmol Jan ;10(2):86-95.

Aims: To assess the Cup disc ratio (CDR) using Heidelberg Retinal Tomograph (HRT) and to correlate the findings with fundus bio-microscopic assessment by a glaucoma specialist, for establishing agreement between the two methods. Study Design: A hospital based cross-sectional comparative analytical study. Methods: 30 eyes of normal subjects and 30 eyes of glaucoma patients were selected from the OPD and Glaucoma Clinic of Al-Shifa Trust Eye Hospital from 10th April 2004 to 10th October 2004. The data for Mean, horizontal and vertical CDR by Fundus Bio-microscopy and HRT were analyzed by the SPSS 10 for finding an agreement or otherwise between the two. Results: In normal subjects, there was strong correlation between the two methods when assessing the mean horizontal and vertical CDR (r =0.718 and 0.769 respectively). The horizontal CDR measured by two methods was correlating well (r = 0.565) but with significant difference in the values (p=0.002). In glaucoma patients, there was good correlation between the two methods in mean, horizontal and vertical CDR values (r = 0.461, 0.490 and 0.357 respectively). Conclusion: There is agreement between the clinical assessment of CDR by a glaucoma specialist and HRT, but clinicians tend to underestimate the horizontal CDR especially in normal individuals. HRT provides real-time reproducible images of the human fundus, which can be used to assess patients with glaucoma.

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