Leung Christopher Kai-shun, Chan Wai-Man, Hui Yung-Lam, Yung Wing-Ho, Woo Jackson, Tsang Moon-Kwong, Tse Kwok-Kay
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Sham Shui Po, Hong Kong, People's Republic of China.
Invest Ophthalmol Vis Sci. 2005 Mar;46(3):891-9. doi: 10.1167/iovs.04-1107.
To evaluate the performance of retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters analyzed with different offsets of reference plane in detecting early glaucomatous changes and in correlation with visual function using optical coherence tomography (OCT).
This was a cross-sectional study consisting of 41 normal subjects and 30 with early and 40 with advanced glaucoma. RNFL thickness and ONH parameters were measured with reference planes positioned at 95, 150, and 205 microm above the level of retinal pigment epithelium (RPE). Discriminating power for early glaucoma detection and correlation with visual field MD for each parameter at different levels of reference plane were compared by using the analyses of area under the receiver operating characteristic curves (AUCs) and linear regression, respectively.
All ONH measurements were significantly different between normal and glaucoma groups, irrespective of the level of reference plane. In normal eyes, changing the reference plane position resulted in significant differences in ONH measurements. Among all the parameters examined, integrated rim volume and RNFL thickness measured at 150 microm above the RPE showed the largest AUC (0.966) for early glaucoma detection, and the strongest correlation with visual function (r = 0.793), respectively.
OCT analysis of the ONH and RNFL is useful for early glaucoma detection. Among the three reference planes examined in this study, measurements analyzed at 150 microm above the RPE demonstrated the best performance for glaucoma detection and correlation with visual function. Compared with ONH measurements, RNFL thickness may be a better indicator, reflecting retinal ganglion cell function and monitoring disease progression.
使用光学相干断层扫描（OCT）评估在不同参考平面偏移量下分析的视网膜神经纤维层（RNFL）厚度和视神经乳头（ONH）参数在检测早期青光眼变化以及与视觉功能相关性方面的表现。
这是一项横断面研究，包括41名正常受试者、30名早期青光眼患者和40名晚期青光眼患者。RNFL厚度和ONH参数在位于视网膜色素上皮（RPE）水平上方95、150和205微米处的参考平面上进行测量。分别通过分析受试者操作特征曲线下面积（AUC）和线性回归，比较不同参考平面水平下各参数检测早期青光眼的鉴别能力以及与视野平均缺损（MD）的相关性。
无论参考平面水平如何，正常组和青光眼组之间所有ONH测量值均存在显著差异。在正常眼中，改变参考平面位置会导致ONH测量值出现显著差异。在所检查的所有参数中，RPE上方150微米处测量的整体视盘边缘体积和RNFL厚度在早期青光眼检测中显示出最大的AUC（0.966），并且与视觉功能的相关性最强（r = 0.793）。
OCT对视神经乳头和视网膜神经纤维层的分析有助于早期青光眼检测。在本研究中检查的三个参考平面中，RPE上方150微米处分析的测量值在青光眼检测以及与视觉功能的相关性方面表现最佳。与ONH测量值相比，RNFL厚度可能是反映视网膜神经节细胞功能和监测疾病进展的更好指标。
