Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
J Glaucoma. 2012 Sep;21(7):498-504. doi: 10.1097/IJG.0b013e318220dbb7.
To compare the glaucoma diagnostic capabilities of optic nerve head (ONH) parameters with retinal nerve fiber layer thickness (RNFLT) using Cirrus spectral-domain optical coherence tomography (Carl Zeiss Meditec Inc, Dublin, CA; version 5.0.0.326).
Two hundred twenty-nine glaucomatous patients, 405 preperimetric glaucoma patients, and 109 healthy individuals were imaged by Cirrus optical coherence tomography optic disc cube mode. Correlations were sought between RNFLT and ONH parameters (disc and rim area, average and vertical cup-to-disc ratio, and cup volume). Areas under receiver operating characteristic curves (AUCs) of average RNFLT were compared with those of ONH parameters with respect to discrimination between glaucomatous patients and healthy individuals. Subgroup analysis was performed in early, moderate-to-advanced glaucomatous groups, glaucoma patients with a small disc area and a large disc area.
Rim area showed the strongest correlation with average RNFLT (r=0.663) and the highest AUC (0.871). The overall AUC for discrimination between healthy individuals and glaucomatous patients was higher for average RNFLT than for rim area (0.957 vs. 0.871, P<0.001). In the early and small disc area subgroup, the AUC of average RNFLT was significantly greater than those of all ONH parameters. In moderate-to-advanced glaucomatous groups' patients, the AUCs of average RNFLT and rim area, in large disc area group patients, the AUC of average RNFLT and vertical cup-to-disc ratio, did not differ significantly.
RNFLT was better than any tested ONH parameter when used for glaucoma discrimination, especially in patients with early-stage glaucoma and in glaucomatous patients with small optic discs.
比较使用 Cirrus 频域光学相干断层扫描仪（Carl Zeiss Meditec Inc，Dublin，CA；版本 5.0.0.326）检测视盘参数和视网膜神经纤维层厚度（RNFLT）在青光眼诊断中的能力。
对 229 例青光眼患者、405 例亚临床青光眼患者和 109 例健康个体进行 Cirrus 光学相干断层扫描仪视盘立方模式成像。分析 RNFLT 与视盘参数（盘面积和环面积、平均和垂直杯盘比以及杯容积）之间的相关性。比较平均 RNFLT 和视盘参数的受试者工作特征曲线（ROC）曲线下面积（AUC）在区分青光眼患者和健康个体方面的差异。在早期、中晚期青光眼组、小视盘面积和大视盘面积的青光眼患者中进行亚组分析。
环面积与平均 RNFLT 的相关性最强（r=0.663），AUC 最高（0.871）。平均 RNFLT 用于区分健康个体和青光眼患者的整体 AUC 高于环面积（0.957 比 0.871，P<0.001）。在早期和小视盘面积亚组中，平均 RNFLT 的 AUC 明显大于所有视盘参数。在中晚期青光眼患者中，平均 RNFLT 和环面积的 AUC 无显著差异，在大视盘面积患者中，平均 RNFLT 和垂直杯盘比的 AUC 无显著差异。
在青光眼诊断中，RNFLT 优于任何测试的视盘参数，尤其是在早期青光眼患者和小视盘青光眼患者中。
