Moon Byung Gil, Sung Kyung Rim, Cho Jung Woo, Kang Sung Yong, Yun Sung-Cheol, Na Jung Hwa, Lee Youngrok, Kook Michael S
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2012 Jun;26(3):174-81. doi: 10.3341/kjo.2012.26.3.174. Epub 2012 May 22.
To evaluate the use of scanning laser polarimetry (SLP, GDx VCC) to measure the retinal nerve fiber layer (RNFL) thickness in order to evaluate the progression of glaucoma.
Test-retest measurement variability was determined in 47 glaucomatous eyes. One eye each from 152 glaucomatous patients with at least 4 years of follow-up was enrolled. Visual field (VF) loss progression was determined by both event analysis (EA, Humphrey guided progression analysis) and trend analysis (TA, linear regression analysis of the visual field index). SLP progression was defined as a reduction of RNFL exceeding the predetermined repeatability coefficient in three consecutive exams, as compared to the baseline measure (EA). The slope of RNFL thickness change over time was determined by linear regression analysis (TA).
Twenty-two eyes (14.5%) progressed according to the VF EA, 16 (10.5%) by VF TA, 37 (24.3%) by SLP EA and 19 (12.5%) by SLP TA. Agreement between VF and SLP progression was poor in both EA and TA (VF EA vs. SLP EA, k = 0.110; VF TA vs. SLP TA, k = 0.129). The mean (±standard deviation) progression rate of RNFL thickness as measured by SLP TA did not significantly differ between VF EA progressors and non-progressors (-0.224 ± 0.148 µm/yr vs. -0.218 ± 0.151 µm/yr, p = 0.874). SLP TA and EA showed similar levels of sensitivity when VF progression was considered as the reference standard.
RNFL thickness as measurement by SLP was shown to be capable of detecting glaucoma progression. Both EA and TA of SLP showed poor agreement with VF outcomes in detecting glaucoma progression.
评估使用扫描激光偏振仪（SLP，GDx VCC）测量视网膜神经纤维层（RNFL）厚度以评估青光眼进展情况。
对47只青光眼患眼进行重测测量变异性测定。纳入152例至少随访4年的青光眼患者的单眼。通过事件分析（EA，Humphrey引导进展分析）和趋势分析（TA，视野指数的线性回归分析）确定视野（VF）损失进展情况。SLP进展定义为与基线测量值（EA）相比，连续三次检查中RNFL减少超过预定的重复性系数。通过线性回归分析（TA）确定RNFL厚度随时间变化的斜率。
根据VF EA，22只眼（14.5%）进展；根据VF TA，16只眼（10.5%）进展；根据SLP EA，37只眼（24.3%）进展；根据SLP TA，19只眼（12.5%）进展。在EA和TA中，VF与SLP进展之间的一致性均较差（VF EA与SLP EA，k = 0.110；VF TA与SLP TA，k = 0.129）。SLP TA测量的RNFL厚度平均（±标准差）进展率在VF EA进展者和非进展者之间无显著差异（-0.224±0.148µm/年对-0.218±0.151µm/年，p = 0.874）。当将VF进展视为参考标准时，SLP TA和EA显示出相似的敏感性水平。
SLP测量的RNFL厚度能够检测青光眼进展。SLP的EA和TA在检测青光眼进展方面与VF结果的一致性均较差。
