Budenz Donald L, Chang Robert T, Huang Xiangrun, Knighton Robert W, Tielsch James M
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida 33136, USA.
Invest Ophthalmol Vis Sci. 2005 Jul;46(7):2440-3. doi: 10.1167/iovs.04-1174.
To determine the reproducibility of Stratus Optical Coherence Tomography (OCT) retinal nerve fiber layer (RNFL) measurements around the optic nerve in normal and glaucomatous eyes.
One eye was chosen at random from 88 normal subjects and 59 glaucomatous subjects distributed among mild, moderate, and severe glaucoma, determined by visual field testing. Subjects underwent six RNFL thickness measurements performed by a single operator over a 30-minute period with a brief rest between sessions. Three scans were taken with the high-density Standard RNFL protocol, and three were taken with the Fast RNFL protocol, alternating between scan protocols.
Reliability, as measured by intraclass correlation coefficient (ICC), was calculated for the overall mean RNFL thickness and for each quadrant. The ICC for the mean Standard RNFL thickness (and lower 95% confidence interval [CI]) in normal and glaucomatous eyes was 0.97 (0.96 CI) and 0.98 (0.97 CI), respectively. The ICC for the mean Fast RNFL thickness in normal and glaucomatous eyes was 0.95 (0.93 CI) and 0.97 (0.95 CI), respectively. Quadrant ICCs ranged between 0.79 and 0.97, with the nasal quadrant being the least reproducible of all four quadrants, using either the Standard or Fast RNFL program. The test-retest variability ranged from 3.5 microm for the average RNFL thickness measurements in normal eyes to 13.8 microm for the nasal quadrant measurements in glaucomatous eyes, which appeared to be the most variable.
Reproducibility of RNFL measurements using the Stratus OCT is excellent in normal and glaucomatous eyes. The nasal quadrant appears to be the most variable measurement. Standard RNFL and Fast RNFL scans are equally reproducible and yield comparable measurements. These findings have implications for the diagnosis of glaucoma and glaucomatous progression.
确定Stratus光学相干断层扫描（OCT）测量正常眼和青光眼眼中视神经周围视网膜神经纤维层（RNFL）的可重复性。
从88名正常受试者和59名青光眼受试者中随机选择一只眼睛，这些青光眼受试者根据视野测试分为轻度、中度和重度青光眼。受试者在30分钟内由一名操作人员进行6次RNFL厚度测量，每次测量之间有短暂休息。使用高密度标准RNFL方案进行3次扫描，使用快速RNFL方案进行3次扫描，两种扫描方案交替进行。
通过组内相关系数（ICC）测量总体平均RNFL厚度和每个象限的可靠性。正常眼和青光眼眼中标准RNFL平均厚度的ICC（及95%置信区间下限[CI]）分别为0.97（0.96 CI）和0.98（0.97 CI）。正常眼和青光眼眼中快速RNFL平均厚度的ICC分别为0.95（0.93 CI）和0.97（0.95 CI）。使用标准或快速RNFL程序时，象限ICC在0.79至0.97之间，其中鼻侧象限的可重复性在所有四个象限中最低。重测变异性范围从正常眼中平均RNFL厚度测量的3.5微米到青光眼眼中鼻侧象限测量的13.8微米，后者似乎是变异性最大的。
使用Stratus OCT测量RNFL在正常眼和青光眼眼中具有出色的可重复性。鼻侧象限似乎是变异性最大的测量部位。标准RNFL和快速RNFL扫描具有同等的可重复性，且测量结果相当。这些发现对青光眼的诊断和青光眼进展具有重要意义。
