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两种光谱域光学相干断层扫描技术测量老年未散瞳眼黄斑中心厚度的比较

Comparison of central macular thickness between two spectral-domain optical coherence tomography in elderly non-mydriatic eyes.

作者信息

Wang Xiao-Gang, Peng Qing, Wu Qiang

机构信息

Department of Ophthalmology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 200233, China.

出版信息

Int J Ophthalmol. 2012;5(3):354-9. doi: 10.3980/j.issn.2222-3959.2012.03.20. Epub 2012 Jun 18.

Abstract

AIM

To compare central macular thickness (CMT) measurements obtained by two spectral-domain optical coherence tomography (SD-OCT) exams, and to evaluate measurement reproducibility and agreement between these two exams, and to investigate the relationship between CMT and possible influencing factors such as age, sex, eye (OD/OS), and operators in elderly non-mydriatic eyes.

METHODS

Seventy-two normal subjects were included. Every subject underwent CMT measurement twice using one of two SD-OCT (OSE-2000, Moptim, Shenzhen, China & 3-D OCT-1000, Topcon, Tokyo, Japan) instruments respectively where we randomly chose one eye in each patient for the test; these exams were performed by two operators over an hour period with a brief rest between sessions. Comparison of the OSE-2000 and 3-D OCT-1000 CMT measurements was based on paired-t test. The mean difference between the CMT measurements was calculated. General linear model analyzed the relationships among eye (OD/OS), operator, sex, and CMT values using age as co-variant. All tests were considered statistically significant at P<0.05. The main outcome measures included CMT.

RESULTS

When evaluated with general linear model analysis, CMT measurements were found to have high reproducibility across the two instruments between the two operators for the OSE-2000 single line scan and 3-D OCT-1000 macular scans (P=0.731; P=0.443). There was statistically significant difference in CMT values between the two instruments (P<0.001) and the mean difference was -46.83µm at 95% confidence limits (-49.15,-44.51). Age was positively correlated with CMT (beta coefficient = 0.516, P=0.001; beta coefficient = 0.453, P=0.009) and sex was correlated with CMT from the OSE-2000 (P=0.021) but not with the 3-D OCT-1000 (P=0.056). According to the actual thickness measurements, the CMT of the male was thicker than the female's but there was no statistical difference. There was interaction between sex and eye in OSE-2000 and not in 3-D OCT-1000 (P=0.02; P=0.374). No significant correlation was found between CMT and the influencing factor of eye in both of the instruments (P=0.884; P=0.492).

CONCLUSION

Reproducibility of CMT measurement using the two SD-OCTs is excellent in normal eyes according to the operator factor analysis. OSE-2000 has a different posterior retinal boundary of CMT measurement, which results in the CMT value differences, compared with the 3-D OCT-1000. Age is positively correlated with CMT measurement while sex is correlated with CMT in the OSE-2000 but not in the 3-D OCT-1000 and eye (OD/OS) had no correlation with CMT values. Mydriatic drops may not be necessary for CMT measurement using high scan rate SD-OCT in normal eyes in dark room.

摘要

目的

比较两次光谱域光学相干断层扫描(SD - OCT)检查所测得的中心黄斑厚度(CMT),评估这两次检查之间测量的可重复性和一致性,并研究老年未散瞳眼中CMT与年龄、性别、眼别(右眼/左眼)及操作者等可能影响因素之间的关系。

方法

纳入72名正常受试者。每位受试者分别使用两台SD - OCT仪器(中国深圳莫廷OSE - 2000和日本东京拓普康3 - D OCT - 1000)之一对CMT进行两次测量,我们在每位患者中随机选择一只眼进行检测;这些检查由两名操作者在一小时内完成,两次检查之间有短暂休息。OSE - 2000和3 - D OCT - 1000的CMT测量结果比较基于配对t检验。计算CMT测量值之间的平均差异。采用一般线性模型,以年龄作为协变量,分析眼别(右眼/左眼)、操作者、性别和CMT值之间的关系。所有检验以P<0.05为差异有统计学意义。主要观察指标为CMT。

结果

通过一般线性模型分析评估时,发现对于OSE - 2000单线扫描和3 - D OCT - 1000黄斑扫描,在两名操作者之间,两台仪器的CMT测量具有较高的可重复性(P = 0.731;P = 0.443)。两台仪器的CMT值存在统计学显著差异(P<0.001),平均差异为 - 46.83μm,95%置信区间为(-49.15,-44.51)。年龄与CMT呈正相关(β系数 = 0.516,P = 0.001;β系数 = 0.453,P = 0.009),性别与OSE - 2000测量的CMT相关(P = 0.021),但与3 - D OCT - 1000测量的CMT无关(P = 0.056)。根据实际测量厚度,男性的CMT比女性厚,但无统计学差异。OSE - 2000中性别与眼别存在交互作用,而3 - D OCT - 1000中不存在(P = 0.02;P = 0.374)。在两台仪器中,CMT与眼别这一影响因素均无显著相关性(P = 0.884;P = 0.492)。

结论

根据操作者因素分析,使用这两种SD - OCT测量CMT在正常眼中的可重复性良好。与3 - D OCT - 1000相比,OSE - 2000测量CMT的视网膜后边界不同,这导致了CMT值的差异。年龄与CMT测量呈正相关,性别与OSE - 2000测量的CMT相关,但与3 - D OCT - 1000测量的CMT无关,眼别(右眼/左眼)与CMT值无关。在暗室中,对于正常眼使用高扫描速率的SD - OCT测量CMT可能无需散瞳。

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