Sihota Ramanjit, Sony Parul, Gupta Viney, Dada Tanuj, Singh Rajvir
Glaucoma Research Facility, Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Invest Ophthalmol Vis Sci. 2006 May;47(5):2006-10. doi: 10.1167/iovs.05-1102.
To evaluate the role and ability of optical coherence tomography (OCT) to detect differences in peripapillary retinal nerve fiber layer (RNFL) thickness between normal and glaucomatous eyes and also between different severities of glaucoma.
This cross-sectional observational study included 160 eyes of 160 healthy subjects and 134 eyes of 134 patients with primary open-angle glaucoma (POAG). Peripapillary RNFL thickness was measured on OCT using the fast RNFL thickness protocol. The RNFL thickness parameters used for evaluation included average RNFL thickness and inferior, superior, nasal, and temporal RNFL thickness. The glaucomatous eyes were subdivided into three subgroups on the basis of visual field defects and a fourth subgroup of eyes blinded by glaucoma. RNFL thickness parameters were compared among the normal eyes and the glaucoma subgroups. Correlation of global visual field indices with RNFL thickness parameters was also performed.
The average RNFL in control subjects, early glaucoma, moderate glaucoma, severe glaucoma, and blind glaucoma were 102.30 +/- 10.34, 77.68 +/- 15.7, 66.07 +/- 15.5, 53.65 +/- 14.2, and 44.93 +/- 4.95 microm, respectively. There was a significant difference in all RNFL thickness parameters between normal and all glaucoma subgroups (P < 0.001). Average and inferior RNFL thicknesses showed the highest area under the receiver operating characteristic curve, with 0.905 and 0.862 for normal versus early glaucoma, 0.705 and 0.722 for early versus moderate glaucoma, 0.737 and 0.717 for moderate versus severe glaucoma, and 0.635 and 0.584 for severe versus blind glaucoma. Both mean deviation (MD) and corrected pattern standard deviation (CPSD) showed a significant correlation with all the RNFL thickness parameters in eyes with glaucoma (P < 0.001).
RNFL thickness measured on OCT may serve as useful adjuncts in accurately and more objectively distinguishing normal from glaucomatous eyes, even in the early stages of glaucoma and may help to differentiate various severities of glaucoma. Average and inferior RNFL thicknesses are among the most efficient parameters for distinguishing such a differentiation. RNFL thicknesses in eyes blinded by glaucoma provide an estimate of the component of the RNFL thickness, which is not related to visual function.
评估光学相干断层扫描（OCT）检测正常眼与青光眼患眼之间以及不同严重程度青光眼患眼之间视乳头周围视网膜神经纤维层（RNFL）厚度差异的作用和能力。
这项横断面观察性研究纳入了160名健康受试者的160只眼和134例原发性开角型青光眼（POAG）患者的134只眼。使用快速RNFL厚度检测方案在OCT上测量视乳头周围RNFL厚度。用于评估的RNFL厚度参数包括平均RNFL厚度以及下方、上方、鼻侧和颞侧RNFL厚度。根据视野缺损将青光眼患眼分为三个亚组，并将因青光眼致盲的患眼作为第四个亚组。比较正常眼和青光眼亚组之间的RNFL厚度参数。还进行了整体视野指标与RNFL厚度参数的相关性分析。
正常对照组、早期青光眼、中度青光眼、重度青光眼和失明青光眼患者的平均RNFL厚度分别为102.30±10.34、77.68±15.7、66.？7±15.5、53.65±14.2和44.93±4.95微米。正常眼与所有青光眼亚组之间的所有RNFL厚度参数均存在显著差异（P<0.001）。平均和下方RNFL厚度在受试者工作特征曲线下的面积最高，正常眼与早期青光眼比较时分别为0.905和0.862，早期与中度青光眼比较时分别为0.705和0.722，中度与重度青光眼比较时分别为0.737和0.717，重度与失明青光眼比较时分别为0.635和0.584。平均偏差（MD）和校正模式标准偏差（CPSD）与青光眼患眼中所有RNFL厚度参数均显示出显著相关性（P<0.001）。
OCT测量的RNFL厚度可作为有用的辅助手段，用于准确、更客观地区分正常眼与青光眼患眼，即使在青光眼早期，并且可能有助于区分不同严重程度的青光眼。平均和下方RNFL厚度是区分这种差异的最有效参数之一。因青光眼致盲的患眼中的RNFL厚度提供了与视觉功能无关的RNFL厚度成分的估计值。
