Effect of Disease Severity on the Performance of Cirrus Spectral-Domain OCT for Glaucoma Diagnosis

PURPOSE. To evaluate the effect of disease severity on the diagnostic accuracy of the Cirrus Optical Coherence Tomograph (Cirrus HD-OCT; Carl Zeiss Meditec, Inc., Dublin, CA) for glaucoma detection. METHODS. One hundred thirty-five glaucomatous eyes of 99 patients and 79 normal eyes of 47 control subjects were recruited from the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). The severity of the disease was graded based on the visual field index (VFI) from standard automated perimetry. Imaging of the retinal nerve fiber layer (RNFL) was obtained using the optic disc cube protocol available on the Cirrus HD-OCT. Pooled receiver operating characteristic (ROC) curves were initially obtained for each parameter of the Cirrus HD-OCT. The effect of disease severity on diagnostic performance was evaluated by fitting an ROC regression model, with VFI used as a covariate, and calculating the area under the ROC curve (AUCs) for different levels of disease severity. RESULTS. The largest pooled AUCs were for average thickness (0.892), inferior quadrant thickness (0.881), and superior quadrant thickness (0.874). Disease severity had a significant influence on the detection of glaucoma. For the average RNFL thickness parameter, AUCs were 0.962, 0.932, 0.886, and 0.822 for VFIs of 70%, 80%, 90%, and 100%, respectively. CONCLUSIONS. Disease severity had a significant effect on the diagnostic performance of the Cirrus HD-OCT and thus should be considered when interpreting results from this device and when considering the potential applications of this instrument for diagnosing glaucoma in the various clinical settings. (Invest Ophthalmol Vis Sci. 2010;51:4104-4109) DOI:10.1167/iovs.094716

A new species of Potamotrygonocestus Brooks & Thorson, 1976 (Eucestoda : Tetraphyllidea) from Plesiotrygon iwamae Rosa, Castello & Thorson (Mylliobatoidea : Potamotrygonidae) and a redescription of Potamotrygonocestus chaoi Marques, Brooks & Araujo, 2003

Potamotrygonocestus Brooks & Thorson, 1976 is currently represented by six recognised species of tetraphyllidean cestodes inhabiting Neotropical freshwater stingrays. Potamotrygonid stingrays examined to date have included only a single specimen of Plesiotrygon iwamae. Only one species of tetraphyllidean, Potamotrygonocestus chaoi Marques, Brooks & Araujo, 2003, has been described from this host, and this description was based on limited material. New efforts to document the diversity in this host species resulted in the collection of eight additional specimens of P. iwamae, one of these from the upper Rio Solimoes, at Sao Paulo de Olivenca Amazonas during September, 2003, and seven from the Baia do Marajo, Para, during November, 2003. The specimen from the upper Solimoees was found to be infected with P. chaoi. Voucher material from this stingray was used for the redescription of this cestode, which is characterized by strobila 8.78-22.83 mm long and a great number of proglottides, 58-93; the new material provided strobilar length and proglottis counts for complete worms. Potamotrygonocestus marajoara n. sp. is the second species of this genus reported from Plesiotrygon iwamae, although it appears to be restricted to the lower Amazon. This new species resembles P. chaoi in possessing filitriches and blade-like spinitriches on the scolex, cephalic peduncle and cirrus, but differs from other species of the genus in the number of testes, which is 44 on average per proglottis, and by having apical sucker measuring 95-175 mu m in length. Additional data on the distribution and morphology of the microtriches and a detailed description of the female reproductive system are also provided in this study.