Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Invest Ophthalmol Vis Sci. 2012 Mar 2;53(3):1139-44. doi: 10.1167/iovs.11-8373.
To investigate whether asymmetry in hemifield macular thickness can serve as an early indicator of glaucomatous structural damage using spectral domain optical coherence tomography.
Five zones in the macular thickness map were defined. Each zone included reciprocal areas in the superior and inferior hemifield. Differences in average retinal thickness (DRT) between corresponding regional pairs were measured in each of the five zones in 50 healthy eyes. An abnormality was defined as the DRT value lying outside the 95% confidence intervals. An eye was considered to yield an "abnormal macular hemifield test" (MHT) if abnormality was evident in any zone. The sensitivity and specificity for glaucoma detection of MHT and average circumpapillary retinal nerve fiber layer (cRNFL) classification were determined.
A total of 114 healthy, 103 glaucoma-suspect, and 74 glaucomatous eyes were included. Overall, 5.8%, 36.9%, 88.4%, and 77.4% of the eyes of the healthy, glaucoma-suspect (GS), early glaucoma (EG), and advanced glaucoma (AG) groups yielded abnormal MHT results, respectively. In EG eyes, the sensitivity of an abnormal MHT result was significantly greater than that of abnormal average cRNFL classification (P=0.008). In the GS and AG groups, the sensitivity did not significantly differ between an abnormal MHT result and an average cRNFL classification (P=0.880, 0.180). Compared with sectoral cRNFL thickness measurements, MHT showed a similar level of diagnostic performance. Specificity was not different between an abnormal MHT result and an average cRNFL classification (P=0.687).
Evaluation of asymmetry in hemifield macular thickness may serve as an assessment tool in the early diagnosis of glaucoma.
利用频域光相干断层扫描研究半视野黄斑厚度的不对称性是否可以作为青光眼结构损伤的早期指标。
在黄斑厚度图上定义了五个区域。每个区域包括上下半视野的对应区域。在 50 只健康眼中的五个区域的每个区域中，测量了相应区域对之间平均视网膜厚度（DRT）的差异。将 DRT 值位于 95%置信区间之外的定义为异常。如果任何区域出现异常，则认为该眼存在“异常黄斑半视野测试”（MHT）。确定 MHT 和平均周边视网膜神经纤维层（cRNFL）分类检测青光眼的敏感性和特异性。
共纳入 114 只健康眼、103 只疑似青光眼眼和 74 只青光眼眼。总体而言，健康组、疑似青光眼组（GS）、早期青光眼组（EG）和晚期青光眼组（AG）中分别有 5.8%、36.9%、88.4%和 77.4%的眼出现异常 MHT 结果。在 EG 眼中，异常 MHT 结果的敏感性明显大于异常平均 cRNFL 分类（P=0.008）。在 GS 和 AG 组中，异常 MHT 结果与平均 cRNFL 分类之间的敏感性无显著差异（P=0.880，0.180）。与节段性 cRNFL 厚度测量相比，MHT 具有相似的诊断性能。异常 MHT 结果与平均 cRNFL 分类之间的特异性无差异（P=0.687）。
评估半视野黄斑厚度的不对称性可能是早期诊断青光眼的一种评估工具。
