Hospital Medicina dos Olhos, São Paulo, Brazil; Federal University of São Paulo, São Paulo, Brazil.
Can J Ophthalmol. 2011 Dec;46(6):543-7. doi: 10.1016/j.jcjo.2011.09.006.
We sought to compare the glaucoma discrimination ability of macular inner retinal layer (MIRL) thickness with that of conventional peripapillary retinal nerve fiber layer (pRNFL) thickness as measured by spectral-domain optical coherence tomography (SD-OCT) in patients with early glaucoma.
Cross-sectional study.
We studied 67 patients with early glaucoma (visual field mean deviation index ≥-6 dB), and 56 healthy subjects were prospectively enrolled.
All patients underwent MIRL thickness measurement (ganglion cell complex [GCC] scan) and pRNFL thickness measurement (3.45 mm scan) by SD-OCT. Whenever both eyes were eligible, one was randomly selected. Receiver operating characteristic curves and sensitivities at fixed specificities were generated for different parameters. The areas under the receiver operating characteristic curves (AUCs) of each parameter were compared.
The average mean deviation for the glaucomatous eyes was -2.5 ± 1.6 dB. The AUCs for average (0.815); superior (0.807); and inferior (0.788) MIRL thicknesses were not significantly different (p ≥ 0.18). The AUCs for average (0.735); superior (0.728); and inferior (0.697) pRNFL thicknesses were also similar (p ≥ 0.15). Average MIRL thickness had a significantly larger AUC compared to average pRNFL thickness analysis (0.815 vs 0.735; p = 0.03). Sensitivities at 80% specificity for average MIRL and pRNFL thicknesses were 66.7% (cutoff, 89.9 μm) and 62.9% (cutoff, 111.8 μm), respectively.
The GCC scan showed a similar or even a slightly better ability to discriminate between healthy and early glaucomatous eyes compared to the pRNFL scan. Different from previous analyses considering total macular thickness, the GCC macular scan seems to be a useful tool for identification of early structural damage in patients with glaucoma.
我们旨在比较黄斑内层视网膜（MIRL）厚度和频域光学相干断层扫描（SD-OCT）测量的传统视盘周围神经纤维层（pRNFL）厚度对早期青光眼患者的青光眼鉴别能力。
横断面研究。
我们研究了 67 名早期青光眼患者（视野平均偏差指数≥-6 dB），前瞻性纳入了 56 名健康受试者。
所有患者均接受 MIRL 厚度测量（神经节细胞复合体[GCC]扫描）和 pRNFL 厚度测量（3.45mm 扫描）。如果双眼均符合条件，则随机选择一只眼。生成不同参数的接收者操作特性曲线和固定特异性下的敏感性。比较每个参数的接收者操作特性曲线下面积（AUC）。
青光眼眼的平均平均偏差为-2.5±1.6dB。平均（0.815）；上方（0.807）；下方（0.788）MIRL 厚度的 AUC 无显著差异（p≥0.18）。平均（0.735）；上方（0.728）；下方（0.697）pRNFL 厚度的 AUC 也相似（p≥0.15）。与平均 pRNFL 厚度分析相比，平均 MIRL 厚度的 AUC 显著更大（0.815 与 0.735；p=0.03）。平均 MIRL 和 pRNFL 厚度的 80%特异性敏感性分别为 66.7%（截断值，89.9μm）和 62.9%（截断值，111.8μm）。
与 pRNFL 扫描相比，GCC 扫描在区分健康眼和早期青光眼眼方面具有相似甚至稍好的能力。与考虑整个黄斑厚度的先前分析不同，GCC 黄斑扫描似乎是识别青光眼患者早期结构损伤的有用工具。
