Moreno-Montañés Javier, Antón Alfonso, García Noelia, Olmo Natalia, Morilla Antonio, Fallon Mónica
Department of Ophthalmology, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
J Glaucoma. 2009 Sep;18(7):528-34. doi: 10.1097/IJG.0b013e318193c29f.
To evaluate the usefulness of retinal nerve fiber layer (RNFL) thickness measurements using the Heidelberg Retina Tomograph-III (HRT-III) in normal, ocular hypertensive, and glaucomatous eyes and compare the thickness measurements using HRT-III and Stratus Optical Coherence Tomography-3 (OCT-3).
Sixty-nine normal eyes, 60 eyes ocular hypertensive, and 111 glaucomatous were included. All participants underwent visual field, HRT-III, and OCT-3 examinations on the same day. Patients were classified into 3 groups according to intraocular pressure and visual field damage. The sensitivity/specificity of RNFL thickness measurements and RNFL thickness classifications using HRT-III and OCT-3 were calculated. The sensitivity/specificity of the height variation contour (HVC) from the HRT-III were calculated. The receiver operating characteristic curves (ROC) and areas under the ROC were plotted. Agreement was calculated using Bland-Altman method and the kappa coefficient.
The RNFL thickness sensitivity/specificity were 32.4%/87%, for the HRT-III and 72.97%/81.15% for the OCT-3 in relation to the glaucoma diagnosis (least specific criteria). The RNFL thickness sensitivities/specificities were lower in early glaucoma. The areas under the ROC for RNFL measurements were 0.72 using HRT-III, 0.86 with OCT-3 (P=0.001), and 0.54 for the HVC. The RNFL classification kappa coefficient was 0.36. Bland-Altman analysis confirmed that the RNFL measurements were not interchangeable.
The sensitivity of RNFL damage detection using HRT-III was lower compared with OCT-3, especially in early glaucoma. RNFL thickness agreement between HRT-III and OCT-3 was only fair. HVC was not useful for glaucoma detection.
评估使用海德堡视网膜断层扫描仪-III（HRT-III）测量正常眼、高眼压症眼和青光眼眼中视网膜神经纤维层（RNFL）厚度的效用，并比较使用HRT-III和Stratus光学相干断层扫描-3（OCT-3）测量的厚度。
纳入69只正常眼、60只高眼压症眼和111只青光眼眼。所有参与者在同一天接受视野、HRT-III和OCT-3检查。根据眼压和视野损害将患者分为3组。计算使用HRT-III和OCT-3测量RNFL厚度的敏感性/特异性以及RNFL厚度分类。计算HRT-III的高度变化轮廓（HVC）的敏感性/特异性。绘制受试者工作特征曲线（ROC）和ROC曲线下面积。使用Bland-Altman方法和kappa系数计算一致性。
对于青光眼诊断（最不严格的标准），HRT-III测量RNFL厚度的敏感性/特异性分别为32.4%/87%，OCT-3为72.97%/81.15%。早期青光眼患者RNFL厚度的敏感性/特异性较低。使用HRT-III测量RNFL的ROC曲线下面积为0.72，OCT-3为0.86（P = 0.001），HVC为0.54。RNFL分类的kappa系数为0.36。Bland-Altman分析证实RNFL测量值不可互换。
与OCT-3相比，使用HRT-III检测RNFL损害的敏感性较低，尤其是在早期青光眼患者中。HRT-III和OCT-3之间RNFL厚度的一致性仅为一般。HVC对青光眼检测无用。
