Reis Alexandre Soares Castro, Vidal Kallene Summer Moreira, Kreuz André Carvalho, Monteiro Mario Luiz Ribeiro, Nicolela Marcelo Teixeira, Malta Roberto Freire Santiago
Department of Ophthalmology, Universidade de São Paulo, Brazil.
Arq Bras Oftalmol. 2012 Jan-Feb;75(1):53-8. doi: 10.1590/s0004-27492012000100011.
To evaluate the retinal nerve fiber layer measurements with time-domain (TD) and spectral-domain (SD) optical coherence tomography (OCT), and to test the diagnostic ability of both technologies in glaucomatous patients with asymmetric visual hemifield loss.
36 patients with primary open-angle glaucoma with visual field loss in one hemifield (affected) and absent loss in the other (non-affected), and 36 age-matched healthy controls had the study eye imaged with Stratus-OCT (Carl Zeiss Meditec Inc., Dublin, California, USA) and 3 D OCT-1000 (Topcon, Tokyo, Japan). Peripapillary retinal nerve fiber layer measurements and normative classification were recorded. Total deviation values were averaged in each hemifield (hemifield mean deviation) for each subject. Visual field and retinal nerve fiber layer "asymmetry indexes" were calculated as the ratio between affected versus non-affected hemifields and corresponding hemiretinas.
Retinal nerve fiber layer measurements in non-affected hemifields (mean [SD] 87.0 [17.1] µm and 84.3 [20.2] µm, for TD and SD-OCT, respectively) were thinner than in controls (119.0 [12.2] µm and 117.0 [17.7] µm, P<0.001). The optical coherence tomography normative database classified 42% and 67% of hemiretinas corresponding to non-affected hemifields as abnormal in TD and SD-OCT, respectively (P=0.01). Retinal nerve fiber layer measurements were consistently thicker with TD compared to SD-OCT. Retinal nerve fiber layer thickness asymmetry index was similar in TD (0.76 [0.17]) and SD-OCT (0.79 [0.12]) and significantly greater than the visual field asymmetry index (0.36 [0.20], P<0.001).
Normal hemifields of glaucoma patients had thinner retinal nerve fiber layer than healthy eyes, as measured by TD and SD-OCT. Retinal nerve fiber layer measurements were thicker with TD than SD-OCT. SD-OCT detected abnormal retinal nerve fiber layer thickness more often than TD-OCT.
采用时域（TD）和频域（SD）光学相干断层扫描（OCT）评估视网膜神经纤维层测量情况，并测试这两种技术对视野不对称性缺损青光眼患者的诊断能力。
36例原发性开角型青光眼患者，一只眼视野缺损（患侧），另一只眼无视野缺损（健侧），36例年龄匹配的健康对照者，对其研究眼采用Stratus-OCT（美国加利福尼亚州都柏林卡尔蔡司医疗技术公司）和3D OCT-1000（日本东京拓普康公司）进行成像。记录视乳头周围视网膜神经纤维层测量值及正常范围分类情况。计算每个受试者每个半视野（半视野平均偏差）的总偏差值。视野和视网膜神经纤维层“不对称指数”计算为患侧与健侧半视野及相应半视网膜之间的比值。
健侧半视野视网膜神经纤维层测量值（TD-OCT和SD-OCT分别为平均[标准差]８７.０[17.1]μm和84.3[20.2]μm）比对照组薄（分别为119.0[12.2]μm和117.０[17.7]μm，P<0.001）。光学相干断层扫描正常数据库将TD-OCT和SD-OCT中分别对应健侧半视野的42%和67%的半视网膜分类为异常（P=0.01）。与SD-OCT相比，TD测量的视网膜神经纤维层始终更厚。视网膜神经纤维层厚度不对称指数在TD（0.76[0.17]）和SD-OCT（0.79[0.12]）中相似，且显著大于视野不对称指数（0.36[0.20]，P<0.001）。
TD-OCT和SD-OCT测量显示，青光眼患者健侧半视野视网膜神经纤维层比健康眼薄。TD测量的视网膜神经纤维层比SD-OCT厚。SD-OCT比TD-OCT更常检测到视网膜神经纤维层厚度异常。
