[视盘照片的传统测量法与数字测量法：一项临床对比研究]

Nguyen N X, Horn F K, Langenbucher A, Mardin C Y

Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen.

Klin Monbl Augenheilkd. 2001 Nov;218(11):727-32. doi: 10.1055/s-2001-18664.

BACKGROUND

The optic disc size is an important parameter for the diagnosis of glaucomatous and non-glaucomatous optic nerve damage. The aim of this study was to compare quantitative measurements of the optic disc with the established conventional planimetry and a new digital method using Soft imaging system analySIS(tm) for Ophthalmology and to determine the reproducibility of this new method.

PATIENTS AND METHODS

Fifty color stereo optic disc photographs of 50 patients (mean age 41.7 +/- 13.4 y) were included in the retrospective, comparative study. Conventional and digital planimetry was taken from one skilled examiner in a masked fashion. According to patient's number measurement values obtained with both methods were matched. Digital planimetric measurements of 10 optic disc photographs were repeated on day 7 and day 14. Statistical analysis was done using linear regression analysis, reliability coefficient and U-test.

RESULTS

The planimetric values did not vary significantly between the two methods for optic disc area (3.19 +/- 0.65 mm(2) vs. 3.03 +/- 0.64 mm(2), p=0.96), for cup area (1.36 +/- 0.62 mm(2) vs. 1.21 +/- 0.63 mm(2), p=0.96) or for neuroretinal rim area (1.83 +/- 0.39 vs. 1.82 +/- 0.41 mm(2), p=0.98). There was also no significant difference of horizontal and vertical diameter of optic disc and cup as well as the diameter of the superior temporal and inferior temporal retinal artery and vein at the optic disc border between both methods (p < 0.5). Differences between measured values for optic disc, optic cup area and neuroretinal rim area obtained with both methods were 0.16 +/- 0.10 mm(2) (range - 0.05 to 0.24), 0.15 +/- 0.10 mm(2) (range - 0.12 to 0.26) and 0.014 +/- 0.11 mm(2) (range - 0.26 to 0.26). A high correlation of all planimetric values was observed between both methods (r=0.9, p < 0.0001). Using digital planimetry differences between day 1, day 7 and day 14 were 0.05 +/- 0.03 (range 0.02 to 0.10 mm(2)) for optic disc, 0.05 +/- 0.04 (range 0.0 to 0.13 mm(2)) for optic cup area and 0.05 +/- 0.05 (range 0.01 to 0.14 mm(2)) for the neuroretinal rim area. The reliability coefficient of digital planimetry was 0.9 for optic disc parameters.

CONCLUSIONS

The comparable results between both methods and a high reproducibility suggest that the digital planimetry could be used either for clinical routine or scientific evaluation of the optic nerve.

背景

视盘大小是诊断青光眼性和非青光眼性视神经损伤的重要参数。本研究的目的是比较视盘的定量测量结果与既定的传统平面测量法以及一种使用眼科软成像系统分析（Soft imaging system analySIS(tm) for Ophthalmology）的新数字方法，并确定该新方法的可重复性。

患者与方法

50例患者（平均年龄41.7±13.4岁）的50张彩色立体视盘照片纳入了这项回顾性比较研究。传统和数字平面测量由一名熟练的检查者以盲法进行。根据患者编号，将两种方法获得的测量值进行匹配。对10张视盘照片的数字平面测量在第7天和第14天重复进行。采用线性回归分析、可靠性系数和U检验进行统计分析。

结果

两种方法对视盘面积（3.19±0.65mm²对3.03±0.64mm²，p = 0.96）、杯盘面积（1.36±0.62mm²对1.21±0.63mm²，p = 0.96）或神经视网膜边缘面积（1.83±0.39对1.82±0.41mm²，p = 0.98）的平面测量值差异均无统计学意义。两种方法对视盘和视杯的水平及垂直直径以及视盘边界处颞上和颞下视网膜动静脉直径的差异也无统计学意义（p < 0.5）。两种方法获得的视盘、视杯面积和神经视网膜边缘面积测量值的差异分别为0.16±0.10mm²（范围 - 0.05至0.24）、0.15±0.10mm²（范围 - 0.12至0.26）和0.014±0.11mm²（范围 - 0.26至0.26）。两种方法之间所有平面测量值均呈现高度相关性（r = 0.9，p < 0.0001）。使用数字平面测量法，视盘在第1天、第7天和第14天的差异为0.05±0.03（范围0.02至0.10mm²），视杯面积为0.05±0.04（范围0.0至0.13mm²），神经视网膜边缘面积为0.05±0.05（范围0.01至0.14mm²）。数字平面测量对视盘参数的可靠性系数为0.9。