Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2012 Oct 5;53(11):6904-13. doi: 10.1167/iovs.12-10210.
To test the glaucoma-discriminating ability of a new method for detecting local ganglion cell loss using spectral-domain optical coherence tomography (OCT).
This study included 58 glaucomatous and 48 healthy eyes from Japanese subjects. Combined thickness of the ganglion cell layer and inner plexus layer (GCIPL) was measured on a macular cube scan in Cirrus HD-OCT. Average GCIPL thickness within a macular elliptical annulus and minimum GCIPL thickness on 360 spokes extending from the inner to the outer radius of the elliptical annulus were calculated. Area under the receiver operating characteristic curve (AROC) to discriminate between healthy eyes and early (mean deviation [MD], ≥-6 dB)/advanced (MD, <-6 dB) glaucomatous were compared between parameters.
Forty-three were normal-tension glaucoma, and 15 were high-tension glaucoma. The mean minimum GCIPL thickness was 77.0 μm in healthy eyes and 60.6 μm in glaucomatous eyes (P < 0.001). For the intersession repeatability, the coefficients of variation for average GCIPL and minimum GCIPL were 0.98 and 1.85 in glaucomatous eyes, and 0.89 and 1.85 in healthy eyes, respectively. Minimum GCIPL thickness AROC (0.896) was significantly higher (P = 0.0062) than average GCIPL thickness (0.821) for early glaucoma, whereas minimum GCIPL AROC (0.991) was comparable (P = 0.103) to average GCIPL (0.964) for advanced glaucoma. The minimum GCIPL thickness AROC was comparable (P = 0.861) to average circumpapillary retinal nerve fiber layer (cpRNFL) thickness (0.890) for early glaucoma.
In Japanese patients with 74.1% of normal-tension glaucoma, the minimum GCIPL on spokes may be useful for detecting early glaucoma.
利用频域光相干断层扫描（OCT）检测局部神经节细胞丢失的新方法来检测青光眼。
本研究纳入了 58 只青光眼眼和 48 只日本正常人眼。在 Cirrus HD-OCT 上对黄斑立方扫描进行测量，得到神经节细胞层和内丛状层（GCIPL）的总和。计算黄斑椭圆环内平均 GCIPL 厚度和从椭圆环内半径到外半径延伸的 360 个辐条上的最小 GCIPL 厚度。比较各参数之间鉴别正常眼和早期（平均偏差[MD]，≥-6dB）/晚期（MD，<-6dB）青光眼的受试者工作特征曲线下面积（AROC）。
43 只为正常眼压性青光眼，15 只为高眼压性青光眼。正常眼的平均最小 GCIPL 厚度为 77.0μm，青光眼眼为 60.6μm（P<0.001）。在两次检测的重复性方面，青光眼眼的平均 GCIPL 和最小 GCIPL 的变异系数分别为 0.98 和 1.85，正常眼分别为 0.89 和 1.85。最小 GCIPL 厚度 AROC（0.896）对早期青光眼的诊断明显高于平均 GCIPL 厚度（0.821）（P=0.0062），而最小 GCIPL 的 AROC（0.991）与平均 GCIPL（0.964）对晚期青光眼的诊断相当（P=0.103）。最小 GCIPL 厚度 AROC 与早期青光眼的平均环周视网膜神经纤维层（cpRNFL）厚度（0.890）相当（P=0.861）。
在日本 74.1%的正常眼压性青光眼患者中，辐条上的最小 GCIPL 可能有助于早期青光眼的检测。
