G. B. Bietti Foundation for the Study and Research in Ophthalmology, IRCCS, Rome, Italy.
J Glaucoma. 2011 Jan;20(1):10-4. doi: 10.1097/IJG.0b013e3181d1d221.
To evaluate the diagnostic assessment of optic nerve heads (ONH) by stereophotography (SP) and Heidelberg retina tomograph (HRT) in patients with retinitis pigmentosa (RP).
This study involved 53 consecutive patients with RP and 24 controls who underwent ONH examination by SP and HRT. On the basis of the appearance at SP, RP ONH were divided in normal-colored (24/53) and pale (29/53). The measurements of vertical ONH diameter and vertical cup/disc ratio (VCDR) by SP and HRT were compared between the groups by means of t test and Bland-Altman plots. Diagnosis, ONH pallor and size, HRT image quality (image standard deviation, SD) were also inspected as sources of differences in the results by means of a multivariate analysis.
Vertical diameter measurements were similar using SP and HRT, respectively (1.93±0.50 and 1.80±0.62 for normal-colored ONH, P=0.43; 2.02±0.65 and 1.90±0.40 for pale ONH, P=0.27; and 1.98±0.55 and 1.84±0.52 for controls, P=0.33). In normal-colored ONH, VCDR was 0.30±0.11 at SP and 0.31±0.21 at HRT (P=0.90); in controls, it was 0.29±0.13 at SP and 0.30±0.18 at HRT (P=0.77). In the group with pale ONH, VCDR was 0.34±0.14 at SP and 0.53±0.24 at HRT (P<0.001). HRT image quality was the only parameter which influenced the difference in VCDR estimates between SP and HRT (P=0.02). In patients with pale ONH, this difference was significantly higher, when images of acceptable quality were used for analysis (0.36±0.15 vs. 0.15±0.21 for images with good quality or better, P=0.03).
In ONH diseases other than glaucoma, HRT may give misleading information when images of acceptable quality are considered for analysis. We therefore recommend the use of images with good quality or better (SD ≤30 μm) in these cases.
评估立体摄影术（SP）和海德堡视网膜断层扫描仪（HRT）对视神经头（ONH）的诊断评估在色素性视网膜炎（RP）患者中的作用。
本研究纳入了 53 例连续的 RP 患者和 24 例对照者，他们均接受了 SP 和 HRT 的 ONH 检查。根据 SP 的外观，将 RP ONH 分为正常色（24/53）和苍白（29/53）。通过 t 检验和 Bland-Altman 图比较 SP 和 HRT 测量的垂直 ONH 直径和垂直杯/盘比（VCDR）。通过多元分析检查诊断、ONH 苍白和大小、HRT 图像质量（图像标准偏差，SD）是否为结果差异的来源。
SP 和 HRT 分别测量的垂直直径相似（正常色 ONH 分别为 1.93±0.50 和 1.80±0.62，P=0.43；苍白 ONH 分别为 2.02±0.65 和 1.90±0.40，P=0.27；对照组分别为 1.98±0.55 和 1.84±0.52，P=0.33）。正常色 ONH 时，SP 上的 VCDR 为 0.30±0.11，HRT 上为 0.31±0.21（P=0.90）；对照组中，SP 为 0.29±0.13，HRT 为 0.30±0.18（P=0.77）。苍白 ONH 组中，SP 上的 VCDR 为 0.34±0.14，HRT 上为 0.53±0.24（P<0.001）。HRT 图像质量是影响 SP 和 HRT 之间 VCDR 估计差异的唯一参数（P=0.02）。在苍白 ONH 患者中，当分析使用可接受质量的图像时，这种差异明显更高（质量好或更好的图像为 0.36±0.15，而质量差或较差的图像为 0.15±0.21，P=0.03）。
在非青光眼的 ONH 疾病中，当考虑可接受质量的图像进行分析时，HRT 可能会提供误导性信息。因此，我们建议在这些情况下使用质量好或更好的图像（SD≤30 μm）。
