Miller E, Caprioli J
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.
Am J Ophthalmol. 1991 Aug 15;112(2):171-6. doi: 10.1016/s0002-9394(14)76697-8.
We studied the variability of optic disk and peripapillary nerve fiber layer surface contour measurements made by use of computer-image analysis. Six hundred twenty-five measurements of surface contour were made on each eye by use of simultaneous stereoscopic videography. Regional differences in short-term measurement variability were studied in 12 eyes (six normal and six glaucomatous), each imaged nine times over several days. The widths of the 95% confidence interval for the measurements averaged 82 microns for the juxta-papillary surface and 132 microns for the disk surface. Measurements of peripapillary surface contour were significantly less variable than were measurements of the disk surface (P = .000). The greatest variability was detected along large blood vessels and at steep contours. Long-term variability was studied in a separate group of 30 clinically stable patients with glaucoma, each imaged three to six times over a period of more than one year. The widths of the 95% confidence intervals were 132 microns for the peripapillary surface and 217 microns for the disk surface. The long-term variability was significantly greater than the short-term variability (P = .000). The peripapillary nerve fiber layer surface, located away from the margins of large vessels, may provide the most dependable measurements of contour. These estimates of long-term variability of optic disk and peripapillary contour measurements provide clinically relevant confidence intervals with which to detect progressive glaucomatous nerve fiber damage.
我们研究了利用计算机图像分析对视盘和视乳头周围神经纤维层表面轮廓进行测量的变异性。通过同步立体摄像对每只眼睛进行了625次表面轮廓测量。在12只眼睛（6只正常眼和6只青光眼眼）中研究了短期测量变异性的区域差异，每只眼睛在几天内进行了9次成像。视乳头旁表面测量的95%置信区间宽度平均为82微米，视盘表面为132微米。视乳头周围表面轮廓的测量变异性明显小于视盘表面的测量变异性（P = 0.000）。在大血管沿线和陡峭轮廓处检测到最大变异性。在另一组30例临床稳定的青光眼患者中研究了长期变异性，每位患者在一年多的时间内进行了3至6次成像。视乳头周围表面的95%置信区间宽度为132微米，视盘表面为217微米。长期变异性明显大于短期变异性（P = 0.000）。远离大血管边缘的视乳头周围神经纤维层表面可能提供最可靠的轮廓测量。对视盘和视乳头周围轮廓测量的长期变异性的这些估计提供了临床上相关的置信区间，用于检测青光眼性神经纤维的进行性损伤。
