Department of Ophthalmology, Hanyang University College of Medicine, Guri Hospital, Gyeonggi-do, Korea.
Invest Ophthalmol Vis Sci. 2010 Mar;51(3):1446-52. doi: 10.1167/iovs.09-4258. Epub 2009 Oct 15.
To evaluate and compare the glaucoma discrimination ability of macular inner retinal layer (MIRL) thickness with that of peripapillary retinal nerve fiber layer (pRNFL) thickness measured by spectral-domain optical coherence tomography (RTVue-100; Optovue Inc, Fremont, CA) in patients with normal-tension glaucoma (NTG).
Sixty-five healthy subjects and 102 with NTG were enrolled. MIRL thickness provided by a ganglion cell complex (GCC) scan and two RNFL thicknesses measured by the NHM4 (RNFL1) and RNFL 3.45 (RNFL2) modes of the RTVue-100 system were analyzed. The areas under the receiver operating characteristic curves (AUCs) of MIRL and pRNFL thicknesses for discriminating patients with NTG from control subjects were determined. The AUCs were compared between patients with central visual field (VF) defects (VF; <or=10 degrees of fixation) and peripheral VF defects (>10 degrees from fixation).
The average MIRL thickness showed a strong correlation with both RNFL1 and -2 thicknesses (R(2) = 0.773, 0.774, both P < 0.0001). The AUCs for average MIRL, RNFL1, and RNFL2 thicknesses were not significantly different at 0.945, 0.973, and 0.976, respectively. However, the AUCs of the average and superior MIRL thicknesses were significantly less than that of the pRNFL thickness in eyes with moderate-to-advanced glaucoma and eyes with peripheral VF defects.
The average MIRL thickness showed a strong correlation with pRNFL thickness, because patients with NTG at an early stage showed paracentral VF defects near the fixation point. MIRL thickness showed glaucoma discrimination ability comparable to that of pRNFL thickness in patients with NTG with early VF defects. In eyes with advanced or peripheral VF defect, pRNFL measurement showed a better glaucoma diagnostic ability than did MIRL measurement.
评估并比较正常眼压性青光眼（NTG）患者黄斑内层视网膜（MIRL）厚度与频域光学相干断层扫描（RTVue-100； Optovue Inc，加利福尼亚州弗里蒙特）测量的视盘周围视网膜神经纤维层（pRNFL）厚度的青光眼鉴别能力。
共纳入 65 名健康受试者和 102 名 NTG 患者。分析了节细胞复合体（GCC）扫描提供的 MIRL 厚度以及 RTVue-100 系统的 NHM4（RNFL1）和 RNFL 3.45（RNFL2）模式测量的两个 RNFL 厚度。确定了用于区分 NTG 患者与对照受试者的 MIRL 和 pRNFL 厚度的受试者工作特征曲线（ROC）下面积（AUC）。比较了有中心视野（VF）缺损（VF；<或=10 度注视）和周边 VF 缺损（>10 度注视）的患者之间的 AUC。
MIRL 平均厚度与 RNFL1 和-2 厚度均具有很强的相关性（R（2）=0.773，0.774，均 P<0.0001）。MIRL、RNFL1 和 RNFL2 平均厚度的 AUC 分别为 0.945、0.973 和 0.976，差异均无统计学意义。然而，在中重度青光眼和周边 VF 缺损的眼中，MIRL 平均和上侧厚度的 AUC 明显小于 pRNFL 厚度的 AUC。
MIRL 平均厚度与 pRNFL 厚度具有很强的相关性，因为早期 NTG 患者在注视点附近出现旁中心 VF 缺损。在早期 VF 缺损的 NTG 患者中，MIRL 厚度显示出与 pRNFL 厚度相当的青光眼鉴别能力。在晚期或周边 VF 缺损的眼中，pRNFL 测量比 MIRL 测量具有更好的青光眼诊断能力。
