Saito Hitomi, Tomidokoro Atsuo, Yanagisawa Mieko, Aihara Makoto, Tomita Goji, Araie Makoto
Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
J Glaucoma. 2008 Jan-Feb;17(1):24-9. doi: 10.1097/IJG.0b013e318133fb47.
To compare the retinal nerve fiber layer thickness (RNFLT) parameters obtained with newly introduced GDx with enhanced corneal compensation (ECC) and those with GDx with variable corneal compensation (VCC) and to evaluate their reproducibility and the correspondence with visual field damage (VFD) in total or sectorized fields in association with refractive errors in open-angle glaucoma (OAG) patients.
Measurement reproducibility was assessed in 30 normal and 30 OAG eyes. Correlation between the RNFLT parameters and the corresponding VFD was evaluated in 58 OAG eyes.
All parameters of both GDx VCC and ECC showed high intraclass correlation coefficients among the repeated measurements (0.89 to 0.99), suggesting good reproducibility. All RNFLT parameters were significantly correlated between VCC and ECC (intraclass correlation coefficient=0.58-0.92, P<0.001) though they were significantly different. In OAG eyes, correlation between temporal, superior, nasal, inferior, temporal average and mean deviation of VFD was similar in both algorithms (Rs=0.58 and 0.53, P<0.001). When the OAG eyes were subgrouped by refractive error at -5 D, the correlation was significant for both ECC and VCC in the lower myopic group (>-5 D) (Rs=0.71 and 0.74, P<0.0001) but was significant only for ECC in the higher myopic group (<or=-5 D) (ECC: Rs=0.44, P=0.016, VCC: Rs=0.19, P=0.309). In all 58 OAG eyes, significant correlation between the sectorized VFD and the corresponding RNFLT was found in the superior arcuate, inferior arcuate, and inferior para-arcuate areas for both VCC and ECC in the sector analysis (P<0.01), whereas the correlation was significant only for ECC (Rs=0.46, P<0.001) but not for VCC (Rs=0.30, P=0.024) in the superior para-arcuate.
The results of GDx ECC were well correlated with those of VCC and had good reproducibility equivalent to that of VCC. Introduction of the ECC algorithm should improve the correspondence with VFD at least in moderate to high myopic OAG patients.
比较新推出的具有增强角膜补偿（ECC）功能的GDx与具有可变角膜补偿（VCC）功能的GDx所获得的视网膜神经纤维层厚度（RNFLT）参数，评估其可重复性以及与开角型青光眼（OAG）患者全视野或扇形视野中视野损害（VFD）的相关性，并结合屈光不正情况进行分析。
对30只正常眼和30只OAG眼进行测量可重复性评估。对58只OAG眼评估RNFLT参数与相应VFD之间的相关性。
GDx VCC和ECC的所有参数在重复测量中均显示出较高的组内相关系数（0.89至0.99），表明具有良好的可重复性。VCC和ECC的所有RNFLT参数之间虽有显著差异，但仍具有显著相关性（组内相关系数=0.58 - 0.92，P<0.001）。在OAG眼中，两种算法下颞侧、上方、鼻侧、下方、颞侧平均VFD与平均偏差之间的相关性相似（Rs=0.58和0.53，P<0.001）。当将OAG眼按-5 D的屈光不正进行亚组划分时，较低近视组（>-5 D）中ECC和VCC的相关性均显著（Rs=0.71和0.74，P<0.0001），而较高近视组（≤-5 D）中仅ECC的相关性显著（ECC：Rs=0.44，P=0.016，VCC：Rs=0.19，P=0.309）。在所有58只OAG眼中，扇形分析显示VCC和ECC在上方弓形、下方弓形和下方旁弓形区域的扇形VFD与相应RNFLT之间均存在显著相关性（P<0.01），而在上方旁弓形区域仅ECC的相关性显著（Rs=0.46，P<0.001），VCC的相关性不显著（Rs=0.30，P=0.024）。
GDx ECC的结果与VCC的结果相关性良好，且具有与VCC相当的良好可重复性。ECC算法的引入至少应能改善中度至高度近视OAG患者中与VFD的相关性。
