Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, FL 33418, USA.
Br J Ophthalmol. 2011 Apr;95(4):502-8. doi: 10.1136/bjo.2010.180810. Epub 2010 Jul 22.
To compare detection of glaucoma progression with scanning laser polarimetry using two methods for corneal compensation.
Normal, glaucoma suspects and glaucoma patients with 36 months' follow-up meeting the eligibility criteria were prospectively enrolled. All subjects underwent complete eye exam, standard automated perimetry (SAP) and scanning laser polarimetry with variable and enhanced corneal compensation (GDxVCC, GDxECC). SAP progression was determined using the visual-field index (VFI). GDx progression was determined using Guided Progression Analysis software (GDxGPA) and was defined as a repeatable change on two consecutive scans compared with two baseline images using any of three strategies: ≥ 150 contiguous pixels on the image progression map (A), four or more adjacent segments on the Temporal Superior Nasal Inferior Temporal graph (B) or a significant change in slope of the summary parameter chart (C). Kappa statistics and logistic regression were used for the analysis.
Thirteen normal, 30 glaucoma suspect and 25 glaucomatous eyes participating in the Advanced Imaging in Glaucoma Study were included. Progression was identified in six eyes (8.8%) using GDxVCC and in eight eyes (11.8%) using GDxECC. SAP progression was detected in seven (10.3%) eyes. Agreement among progression methods using GDxVCC and GDxECC was strongest for method C (kappa=0.57, p=0.002) compared with methods A (kappa=0.41, p=0.01) and B (kappa=0.41, p=0.01). The association between typical scan score (TSS) and overall or individual methods of progression was not significant using VCC or ECC (p>0.05).
GDxGPA represents a novel approach for detection of glaucomatous progression. GDxVCC and GDxECC demonstrate moderate agreement.
比较两种角膜补偿方法的扫描激光偏振仪检测青光眼进展的情况。
符合入选标准的具有 36 个月随访的正常、青光眼疑似患者和青光眼患者被前瞻性纳入研究。所有受试者均接受全面的眼部检查、标准自动视野计（SAP）和具有可变及增强角膜补偿的扫描激光偏振仪（GDxVCC、GDxECC）检查。使用视野指数（VFI）来确定 SAP 进展。使用 Guided Progression Analysis 软件（GDxGPA）来确定 GDx 进展，并将其定义为与基线图像相比，在任意两种策略下连续两次扫描的重复变化：图像进展图上≥150 个连续像素（A）、Temporal Superior Nasal Inferior Temporal 图上四个或更多相邻段（B）或总结参数图中斜率的显著变化（C）。使用 Kappa 统计和逻辑回归进行分析。
共有 13 只正常眼、30 只青光眼疑似眼和 25 只青光眼眼参与了 Advanced Imaging in Glaucoma 研究，其中 6 只眼（8.8%）使用 GDxVCC 检测到进展，8 只眼（11.8%）使用 GDxECC 检测到进展。7 只眼（10.3%）使用 SAP 检测到进展。使用 GDxVCC 和 GDxECC 的进展方法之间的一致性，以方法 C 最强（kappa=0.57，p=0.002），与方法 A（kappa=0.41，p=0.01）和 B（kappa=0.41，p=0.01）相比。使用 VCC 或 ECC，TSS 与整体或个别进展方法之间没有显著关联（p>0.05）。
GDxGPA 代表了一种检测青光眼进展的新方法。GDxVCC 和 GDxECC 显示出中等程度的一致性。
