Rolle Teresa, Briamonte Cristina, Curto Daniela, Grignolo Federico Maria
Eye Clinic, Section of Ophthalmology, Department of Clinical Physiopathology, University of Torino, Torino, Italy.
Clin Ophthalmol. 2011;5:961-9. doi: 10.2147/OPTH.S20249. Epub 2011 Jul 13.
To evaluate the capability of Fourier-domain optical coherence tomography (FD-OCT) to detect structural damage in patients with preperimetric glaucoma.
A total of 178 Caucasian subjects were enrolled in this cohort study: 116 preperimetric glaucoma patients and 52 healthy subjects. Using three-dimensional FD-OCT, the participants underwent imaging of the ganglion cell complex (GCC) and the optic nerve head. Sensitivity, specificity, likelihood ratios, and predictive values were calculated for all parameters at the first and fifth percentiles. Areas under the curves (AUCs) were generated for all parameters and were compared (Delong test). For both the GCC and the optic nerve head protocols, the OR logical disjunction (Boolean logic operator) was calculated.
The AUCs didn't significantly differ. Macular global loss volume had the largest AUC (0.81). Specificities were high at both the fifth and first percentiles (up to 97%), but sensitivities were low, especially at the first percentile (55%-27%).
Macular and papillary diagnostic accuracies did not differ significantly based on the 95% confidence interval. The computation of the Boolean OR operator has been found to boost diagnostic accuracy. Using the software-provided classification, sensitivity and diagnostic accuracy were low for both the retinal nerve fiber layer and the GCC scans. FD-OCT does not seem to be decisive for early detection of structural damage in patients with no functional impairment. This suggests that there is a need for analysis software to be further refined to enhance glaucoma diagnostic capability.
评估傅里叶域光学相干断层扫描（FD - OCT）检测视野缺损前青光眼患者结构损伤的能力。
本队列研究共纳入178名白种人受试者：116名视野缺损前青光眼患者和52名健康受试者。使用三维FD - OCT对参与者的神经节细胞复合体（GCC）和视神经乳头进行成像。计算第一和第五百分位数时所有参数的敏感性、特异性、似然比和预测值。生成所有参数的曲线下面积（AUC）并进行比较（德龙检验）。对于GCC和视神经乳头方案，计算或逻辑析取（布尔逻辑运算符）。
AUC无显著差异。黄斑整体损失体积的AUC最大（0.81）。第五和第一百分位数时特异性均较高（高达97%），但敏感性较低，尤其是在第一百分位数时（55% - 27%）。
基于95%置信区间，黄斑和视乳头的诊断准确性无显著差异。已发现计算布尔或运算符可提高诊断准确性。使用软件提供的数据分类，视网膜神经纤维层和GCC扫描的敏感性和诊断准确性均较低。对于无功能损害的患者，FD - OCT似乎对早期结构损伤检测不起决定性作用。这表明需要进一步完善分析软件以提高青光眼诊断能力。
