Leung Christopher Kai-shun, Medeiros Felipe A, Zangwill Linda M, Sample Pamela A, Bowd Christopher, Ng Diana, Cheung Carol Yim Lui, Lam Dennis Shun Chiu, Weinreb Robert N
Hamilton Glaucoma Center, University of California, San Diego, California, USA.
Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2644-52. doi: 10.1167/iovs.06-1332.
To compare the relationships between optic nerve structural measures and visual function, as well as the diagnostic sensitivity for glaucoma detection between the retinal nerve fiber layer (RNFL) and neuroretinal rim measurements.
A total of 101 normal and 156 glaucomatous eyes of 257 enrolled subjects were examined. RNFL thickness was measured by optical coherence tomography, and the neuroretinal rim (rim area, rim/disc area, and rim volume) was measured with a confocal scanning laser ophthalmoscope. The relationship between the structural measures and visual field sensitivity was evaluated with linear and non-linear-regression (quadratic and logarithmic) models. The coefficient of determination (R2) was calculated, and the regression models were compared with Alkaike's information criteria and the F test. The diagnostic sensitivity for glaucoma detection in each structural measure was determined by the area under the receiver operating characteristic curve (AUC).
The relationship of the RNFL, rim area, rim/disc area, and rim volume with visual function was best described with nonlinear regression models (quadratic regression for the RNFL [R2 = 0.383]), rim area [R2 = 0.303]), and rim/disc area [R2 = 0.265]; and logarithmic regression for rim volume [R2 = 0.175]). The change of visual sensitivity at each level of structural damage was highest for the RNFL. The AUC for the RNFL also was higher than the neuroretinal rim measures. In this study population, at 90% specificity, the diagnostic sensitivities for detecting glaucomatous damage was 82.7%, 67.3%, 67.3%, and 52.6% for the RNFL, rim area, rim/disc area, and rim volume, respectively. (These values would apply only to a group with inclusion criteria and disease severity similar to those of the present cohort.)
The RNFL showed a stronger structure-function association and a higher diagnostic sensitivity for glaucoma detection than did the neuroretinal rim.
比较视神经结构测量值与视觉功能之间的关系，以及视网膜神经纤维层（RNFL）和神经视网膜边缘测量值对青光眼检测的诊断敏感性。
对257名入选受试者的101只正常眼和156只青光眼眼进行了检查。通过光学相干断层扫描测量RNFL厚度，并用共焦扫描激光检眼镜测量神经视网膜边缘（边缘面积、边缘/视盘面积和边缘体积）。用线性和非线性回归（二次和对数）模型评估结构测量值与视野敏感度之间的关系。计算决定系数（R2），并将回归模型与赤池信息准则和F检验进行比较。通过受试者操作特征曲线（AUC）下的面积确定每种结构测量对青光眼检测的诊断敏感性。
RNFL、边缘面积、边缘/视盘面积和边缘体积与视觉功能的关系用非线性回归模型描述最佳（RNFL的二次回归[R2 = 0.383]、边缘面积[R2 = 0.303]和边缘/视盘面积[R2 = 0.265]；边缘体积的对数回归[R2 = 0.175]）。在结构损伤的每个水平上，RNFL的视觉敏感度变化最高。RNFL的AUC也高于神经视网膜边缘测量值。在本研究人群中，在90%的特异性下，RNFL、边缘面积、边缘/视盘面积和边缘体积检测青光眼损伤的诊断敏感性分别为82.7%、67.3%、67.3%和52.6%。（这些值仅适用于具有与本队列相似的纳入标准和疾病严重程度的组。）
与神经视网膜边缘相比，RNFL显示出更强的结构-功能关联和更高的青光眼检测诊断敏感性。
