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Imaging and Navigation
Table 3: Studies of Optical Coherence Tomography
Author Imaging Study Population Reference QUADAS Comments
Device Standard Item Y/N
Leung, 2009
39
Time vs spectral- Glaucoma vs healthy Visual fields 9/3 Diagnostic performance between

domain OCT 1 unclear the two OCT is comparable;
(Stratus vs Cirrus) poor agreement of measurements
Sehi, 2009
38
Time vs Fourier- Glaucoma vs healthy Visual fields 9/3 Comparable diagnostic performance

domain OCT 1 unclear
Zhong, 2009
41
Stratus OCT Pre-perimetric glaucoma Stereo colour 10/1 Sensitivity of Stratus OCT RNFL

vs healthy photography 2 unclear thickness parameters is low for
detecting pre-perimetric glaucoma
Hougaard, 2007
60
Stratus OCT Glaucoma with mild VF Stereo and RNFL 10/2 OCT summary report parameters

defects vs healthy photography 1 unclear show only moderate diagnostic
sensitivity, especially in patients
with mild glaucoma; diagnostic
potential of OCT not fully exploited
Anton, 2007
42
Stratus OCT Healthy vs patients with OHT Visual fields 9/3 RNFL and ONH parameters

and manifest glaucoma 1 unclear differentiate well between healthy and
glaucomatous; significant differences
between OHT and healthy eyes for
some OHN parameters
Lee, 2009
61
Stratus OCT Glaucoma, progressing Red-free RNFL 11/1 Stratus OCT detects progressive

vs stable photography 1 unclear RNFL loss with high sensitivity
and moderate specificity
Gyathso, 2008
43
Stratus OCT Healthy vs glaucoma Red-free RNFL and 11/1 Only study that provides sample

and OHT colour stereoscopic 1 unclear size calculation; Stratus OCT
photography detects significant quantitative
differences in RNFL thickness
between all three groups
Nouri-Mahdavi, 2008
40
Stratus OCT Early disc or visual field Stereoscopic 11/1 Interesting approach to define a

changes vs normal photography and 1 unclear reference standard; poor
visual field performance in patients with optic
disc changes but normal fields (50%);
better performance in more
advanced disease
Hood, 2007
62
Stratus OCT Healthy vs glaucoma Visual field 7/4 OCT detects glaucoma confirmed with

(hemi-field test) 2 unclear subjective and objective functional
and mVEP tests (cave: diagnostic performance
assessed in advanced disease)
mVEP = multifocal visual evoked potential; OCT = optical coherence tomography; OHT = ocular hypertension; ONH = optic nerve head; QUADAS = Quality Assessment of Diagnostic
Accuracy Studies; RNFL = retinal nerve fibre layer; VF = visual field.
Table 4: The QUADAS Assessment Tool
Item Yes No Unclear
1. Was the spectrum of patients representative of the patients who will receive the test in practice? ( ) ( ) ( )
2. Were selection criteria clearly described? ( ) ( ) ( )
3. Is the reference standard likely to correctly classify the target condition? ( ) ( ) ( )
4. Is the time period between reference standard and index test short enough to be reasonably sure that the target ( ) ( ) ( )
condition did not change between the two tests?
5. Did the whole sample or a random selection of the sampe receive verification using a reference standard ( ) ( ) ( )
of diagnosis?
6. Did patients receive the same reference standard regardless of the index test result? ( ) ( ) ( )
7. Was the reference standard independent of the index test (i.e. the index test did not form a part of the ( ) ( ) ( )
reference standard)?
8. Was the execution of the index test described in sufficient detail to permit replication of the test? ( ) ( ) ( )
9. Was the execution of the reference standard described in sufficient detail to permit its replication? ( ) ( ) ( )
10. Were the index test results interpreted without knowledge of the results of the reference standard? ( ) ( ) ( )
11. Were the reference standard results interpreted without knowledge of the results of the index test? ( ) ( ) ( )
12. Were the same clinical data available when test results were interpreted as would be available when the ( ) ( ) ( )
test is used in practice?
13. Were uninterpretable/intermediate test results reported? ( ) ( ) ( )
14. Were withdrawals from the study explained? ( ) ( ) ( )
QUADAS = Quality Assessment of Diagnostic Accuracy Studies.
20 EUROPEAN OPHTHALMIC REVIEW
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