Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Eye (Lond). 2011 Jan;25(1):17-29. doi: 10.1038/eye.2010.155. Epub 2010 Nov 19.
To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT).
The study included 330 experienced participants in five age-related groups: 77 'preperimetric' open-angle glaucoma (OAG) patients, 52 'early' OAG, 50 'moderate' OAG, 54 ocular hypertensive patients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an 'FDT-score', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%.
Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG.
Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone.
评估频域光学相干断层扫描（SD-OCT）的视网膜神经纤维层（RNFL）厚度测量与频率加倍技术（FDT）之间的联合诊断能力。
该研究纳入了五个年龄相关组的 330 名经验丰富的参与者：77 名“前期”开角型青光眼（OAG）患者、52 名“早期”OAG 患者、50 名“中度”OAG 患者、54 名高眼压患者和 97 名健康受试者。所有受试者均进行常规视野检查、眼底照片评估、FDT 视野检查和 SDOCT 的 RNFL 厚度测量以评估青光眼。使用青光眼分期系统对青光眼视野缺损进行分类。FDT 评估使用已发表的方法，对每个病例进行“FDT 评分”的计算，包括所有错过的局部概率水平。SD-OCT 评估使用平均 RNFL 厚度和新的个体 SDOCT 评分，考虑到周边圆形扫描 32 个扇区的正常置信限。为了检验两种方法的联合价值，引入了一个联合评分。使用特异性为 96%的方法计算接收者操作特征（ROC）曲线之间差异的显著性。
在前期青光眼组中，SD-OCT 评分的敏感性为 44%，FDT 评分的敏感性为 25%，联合评分的敏感性为 44%，在早期青光眼组中，敏感性分别为 83%、81%和 89%，在中度青光眼组中，敏感性分别为 94%、94%和 98%，特异性均为 96%。新开发的联合评分的 ROC 性能明显优于 FDT 评分在前期和早期 OAG 中的单一 ROC 曲线，优于中度 OAG 中的 RNFL 厚度。
使用 FDT 评分和 SDOCT 评分对功能和形态进行联合，其表现与单独使用每种方法一样，甚至更好。
