Accurate assessment of optic nerve and nerve fiber layer (NFL) structure is important to the early detection and timely treatment of glaucoma.
The specific aims of this revised application are to: 1) develop novel structural measures of the optic nerve and NFL which are sensitive and specific for early and progressive glaucomatous optic nerve damage; 2) determine the diagnostic precision of existing and novel measures to detect the presence of early structural damage; 3) determine the diagnostic precision of existing and novel measures to detect the progression of structural damage; and 4) identify and validate methods that provide the most sensitive and specific measures of early glaucomatous structural damage. The techniques to be tested include but are not limited to: qualitative and quantitative assessment of color optic disc stereophotographs, qualitative and quantitative assessment of monochromatic NFL photographs, and scanning confocal laser image analysis of the optic nerve head and NFL. Cross-sectional analysis in age-matched normal and glaucomatous eyes will determine which techniques best detect the presence of glaucoma defined by early, reproducible visual field loss. A longitudinal study in progress will continue to follow normal subjects, ocular hypertensives and glaucoma patients to determine the sensitivity and specificity of various measures to identify change. Sensitivity and specificity will be determined for each measure and comparisons facilitated with receiver operating characteristic curves. Discriminant analysis and neural networks will be used to test the effectiveness of combined measures, and to estimate the probability that damage is present in individual eyes. Long-term follow-up of a well established cohort of subjects will enable early changes in structure to be validated by the subsequent development or worsening of visual field loss. This study will provide appropriately controlled, quantitative information to identify the most sensitive and specific methods to detect and monitor glaucoma damage in practice, and to define the most appropriate outcome measures for clinical trials and studies of glaucoma care.
| Nouri-Mahdavi, Kouros; Nikkhou, Kiavash; Hoffman, Douglas C et al. (2008) Detection of early glaucoma with optical coherence tomography (StratusOCT). J Glaucoma 17:183-8 |
| Badala, Federico; Nouri-Mahdavi, Kouros; Raoof, Duna A et al. (2007) Optic disk and nerve fiber layer imaging to detect glaucoma. Am J Ophthalmol 144:724-32 |
| Nouri-Mahdavi, Kouros; Hoffman, Douglas; Ralli, Monica et al. (2007) Comparison of methods to predict visual field progression in glaucoma. Arch Ophthalmol 125:1176-81 |
| Caprioli, Joseph; Nouri-Mahdavi, Kouros; Law, Simon K et al. (2006) Optic disc imaging in perimetrically normal eyes of glaucoma patients with unilateral field loss. Trans Am Ophthalmol Soc 104:202-11 |
| Manassakorn, Anita; Nouri-Mahdavi, Kouros; Caprioli, Joseph (2006) Comparison of retinal nerve fiber layer thickness and optic disk algorithms with optical coherence tomography to detect glaucoma. Am J Ophthalmol 141:105-115 |
| Manassakorn, Anita; Nouri-Mahdavi, Kouros; Koucheki, Behrooz et al. (2006) Pointwise linear regression analysis for detection of visual field progression with absolute versus corrected threshold sensitivities. Invest Ophthalmol Vis Sci 47:2896-903 |
| Ralli, Monica; Nouri-Mahdavi, Kouros; Caprioli, Joseph (2006) Outcomes of laser suture lysis after initial trabeculectomy with adjunctive mitomycin C. J Glaucoma 15:60-7 |
| Nouri-Mahdavi, Kouros; Caprioli, Joseph; Coleman, Anne L et al. (2005) Pointwise linear regression for evaluation of visual field outcomes and comparison with the advanced glaucoma intervention study methods. Arch Ophthalmol 123:193-9 |
| Nouri-Mahdavi, Kouros; Hoffman, Douglas; Gaasterland, Douglas et al. (2004) Prediction of visual field progression in glaucoma. Invest Ophthalmol Vis Sci 45:4346-51 |
| Nouri-Mahdavi, Kouros; Hoffman, Douglas; Coleman, Anne L et al. (2004) Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study. Ophthalmology 111:1627-35 |
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