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Impressum
Flicker comparison of optic disc photographs: sensitivity and specificity
1Funk J., 1Lagreze W., 2Zeyen T.
1Universitäts-Augenklinik Freiburg, 2University Hospital, Department of Ophthalmology, K. U. Leuven, Belgium
Purpose: Examination and documentation of the optic nerve head
are essential in monitoring glaucoma patients. Even minor changes in optic
nerve head morphology can be visualized using the so-called flicker test:
Two optic nerve head photographs, taken at consecutive examinations, are
superimposed by projection. When occluding the pictures in a rapid alternating
fashion, changes in optic nerve head morphology appear as motion. In this
study, we evaluated sensitivity and specificity of the flicker test.
Method: A set of 33 pairs of serial optic disc slides was used
as a gold standard. These 33 pairs had been classified earlier by 3 independent
groups of experts. 23 had been classified as "no change over time",
10 had been classified as "change". All 33 pairs were now evaluated
by flicker comparison in a masked fashion.
Results: Flicker comparison usually took 1 minute per pair of slides.
Sensitivity was 90%, specificity was 65%.
Conclusion: The sensitivity was reasonably high. The moderate specificity
was due to some cases showing "change" with the flicker comparison
which might have been overlooked by the expert groups. Flicker comparison
is an easy, fast and reliable technique to evaluate pairs of consecutive
optic disc photographs.