Hamilton Glaucoma Center, Department of Ophthalmology, University of California San Diego, La Jolla, USA.
Am J Ophthalmol. 2011 Jan;151(1):85-92.e1. doi: 10.1016/j.ajo.2010.06.041. Epub 2010 Oct 20.
To assess the agreement of parapapillary retinal nerve fiber layer (RNFL) thickness measurements among 3 spectral-domain optical coherence tomography (SD-OCT) instruments.
Observational, cross-sectional study.
Three hundred thirty eyes (88 with glaucoma, 206 glaucoma suspects, 36 healthy) from 208 individuals enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) were imaged using RTVue, Spectralis and Cirrus in a single visit. Agreement among RNFL thickness measurements was assessed using Bland-Altman plots. The influence of age, axial length, disc size, race, spherical equivalent, and disease severity on the pairwise agreements between different instruments was assessed by regression analysis.
Although RNFL thickness measurements between different instruments were highly correlated, Bland-Altman analyses indicated the presence of fixed and proportional biases for most of the pairwise agreements. In general, RTVue measurements tended to be thicker than Spectralis and Cirrus measurements. The agreement in average RNFL thickness measurements between RTVue and Spectralis was affected by age (P = .001) and spherical equivalent (P < .001), whereas the agreement between Spectralis and Cirrus was affected by axial length (P = .004) and spherical equivalent (P < .001). Disease severity influenced the agreement between Spectralis and both RTVue and Cirrus (P = .001). Disc area and race did not influence the agreement among the devices.
RNFL thickness measurements obtained by different SD-OCT instruments were not entirely compatible and therefore they should not be used interchangeably. This may be attributable in part to differences in RNFL detection algorithms. Comparisons with histologic measurements could determine which technique is most accurate.
评估 3 种频域光学相干断层扫描（SD-OCT）仪器测量视盘旁视网膜神经纤维层（RNFL）厚度的一致性。
观察性、横断面研究。
共有 208 名个体的 330 只眼（88 只患有青光眼，206 只青光眼疑似患者，36 只健康）纳入诊断性青光眼创新研究（DIGS），并在一次就诊中使用 RTVue、Spectralis 和 Cirrus 进行成像。使用 Bland-Altman 图评估 RNFL 厚度测量值之间的一致性。通过回归分析评估年龄、眼轴长度、视盘大小、种族、等效球镜和疾病严重程度对不同仪器之间两两协议的影响。
尽管不同仪器的 RNFL 厚度测量值高度相关，但 Bland-Altman 分析表明，大多数两两协议存在固定和比例偏差。一般来说，RTVue 测量值比 Spectralis 和 Cirrus 测量值厚。RTVue 和 Spectralis 平均 RNFL 厚度测量值之间的一致性受年龄（P =.001）和等效球镜（P <.001）的影响，而 Spectralis 和 Cirrus 之间的一致性受眼轴长度（P =.004）和等效球镜（P <.001）的影响。疾病严重程度影响 Spectralis 与 RTVue 和 Cirrus 之间的一致性（P =.001）。视盘面积和种族不影响仪器之间的一致性。
不同 SD-OCT 仪器测量的 RNFL 厚度值不完全兼容，因此不应互换使用。这可能部分归因于 RNFL 检测算法的差异。与组织学测量值进行比较可以确定哪种技术最准确。
