Moura Frederico C, Medeiros Felipe A, Monteiro Mário L R
Division of Ophthalmology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Ophthalmology. 2007 Jan;114(1):175-81. doi: 10.1016/j.ophtha.2006.06.045. Epub 2006 Oct 27.
To evaluate the ability of optical coherence tomography (OCT) macular thickness parameters to differentiate between eyes with band atrophy (BA) of the optic nerve and healthy eyes.
Cross-sectional study.
The study included 1 eye of each of 40 consecutive patients with BA of the optic nerve and permanent temporal hemianopic visual field (VF) defects owing to chiasmal compression and 31 age- and gender-matched healthy subjects.
All patients underwent VF assessment with kinetic Goldmann perimetry and Humphrey 24-2 full-threshold standard automated perimetry (SAP). Macular and retinal nerve fiber layer (RNFL) thickness scans were obtained using the commercially available Stratus OCT. The severity of VF defect in patients with BA was evaluated by the temporal mean defect (TMD), calculated as the average of the 22 values of the temporal total deviation plot of the SAP 24-2 test, excluding the 2 points immediately above and below the blind spot.
Receiver operating characteristic (ROC) curves and sensitivities at fixed specificities were calculated for each parameter. Spearman's rank correlation coefficients were used to evaluate the relationship between RNFL and macular thickness parameters and severity of VF loss as measured by the TMD.
The macular thickness parameters related to the nasal hemiretina had the best performance to detect damage in BA eyes. No statistically significant difference (P = 0.19) was found between the ROC curve areas (AUCs) for the best macular thickness parameter (temporal/nasal macular thickness, AUC = 0.96) and the best RNFL parameter (average thickness, AUC = 0.99). Lower values of TMD, indicating more severe VF loss, were associated with lower macular thickness measurements. The highest correlation was observed for the parameter nasal average macular thickness (rho = 0.693, R2 = 48%, P<0.001).
Eyes with BA of the optic nerve show significant thinning of the retinal thickness on the nasal macular area, which is associated with the severity of VF damage in these eyes. Macular thickness measurements could potentially be used to evaluate the amount of ganglion cell loss in patients with BA of the optic nerve and could prove clinically useful for detection of damage and for monitoring these patients.
评估光学相干断层扫描（OCT）黄斑厚度参数区分视神经带状萎缩（BA）眼和健康眼的能力。
横断面研究。
该研究纳入了40例连续的因视交叉受压导致视神经BA和永久性颞侧偏盲视野（VF）缺损患者的单眼，以及31名年龄和性别匹配的健康受试者。
所有患者均接受了动态Goldmann视野计和Humphrey 24-2全阈值标准自动视野计（SAP）的VF评估。使用市售的Stratus OCT获得黄斑和视网膜神经纤维层（RNFL）厚度扫描。BA患者VF缺损的严重程度通过颞侧平均缺损（TMD）进行评估，计算方法为SAP 24-2测试颞侧总偏差图的22个值的平均值，不包括盲点上方和下方紧邻的2个点。
计算每个参数的受试者操作特征（ROC）曲线和固定特异性下的敏感性。采用Spearman等级相关系数评估RNFL和黄斑厚度参数与通过TMD测量的VF丧失严重程度之间的关系。
与鼻侧半视网膜相关的黄斑厚度参数在检测BA眼中的损伤方面表现最佳。最佳黄斑厚度参数（颞侧/鼻侧黄斑厚度，AUC = 0.96）和最佳RNFL参数（平均厚度，AUC = 0.99）的ROC曲线面积（AUC）之间未发现统计学显著差异（P = 0.19）。TMD值越低，表明VF丧失越严重，与黄斑厚度测量值越低相关。观察到鼻侧平均黄斑厚度参数的相关性最高（rho = 0.693，R2 = 48%，P<0.001）。
视神经BA眼的鼻侧黄斑区视网膜厚度明显变薄，这与这些眼中VF损伤的严重程度相关。黄斑厚度测量可能有助于评估视神经BA患者神经节细胞丧失的程度，并可能在临床上用于检测损伤和监测这些患者。
