频域与时域光学相干断层扫描在视野缺损前青光眼诊断中的能力
Diagnostic ability of spectral-domain versus time-domain optical coherence tomography in preperimetric glaucoma.
作者信息
Jeoung Jin Wook, Kim Tae-Woo, Weinreb Robert N, Kim Seok Hwan, Park Ki Ho, Kim Dong Myung
机构信息
*Department of Ophthalmology, Seoul National University College of Medicine †Department of Ophthalmology, Seoul National University Hospital ∥Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul ‡Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea §Hamilton Glaucoma Center and Department of Ophthalmology, University of California San Diego, La Jolla, CA.
出版信息
J Glaucoma. 2014 Jun-Jul;23(5):299-306. doi: 10.1097/IJG.0b013e3182741cc4.
PURPOSE
To evaluate and compare the diagnostic abilities of the speckle noise-reduced spectral-domain optical coherence tomography (SD-OCT; Spectralis OCT) and time-domain optical coherence tomography (TD-OCT; Stratus OCT) to detect localized retinal nerve fiber layer (RNFL) defects in patients with preperimetric open-angle glaucoma.
METHODS
Thirty-five eyes of 35 preperimetric glaucoma patients with localized RNFL defects and 72 normal control eyes were scanned using SD-OCT and TD-OCT. Areas under the receiver-operating characteristic curves (AUROCs), and the sensitivity and specificity for detecting localized RNFL defects based on the internal normative database of each device were calculated and compared.
RESULTS
The AUROC for the best parameter from SD-OCT (inferotemporal sector, AUROC=0.940) was significantly higher than that of TD-OCT (7 o'clock sector, AUROC=0.881; P=0.009). The sensitivity of the SD-OCT parameters ranged from 18.9% to 83.8% and that of the TD-OCT parameters ranged from 5.4% to 54.1%, with the criterion of abnormal at the 5% level. The highest sensitivity of the SD-OCT was found with the temporal-superior-nasal-inferior-temporal thickness graph abnormal at the 5% level, which had a specificity of 90.3%. On the basis of temporal-superior-nasal-inferior-temporal thickness graphs, SD-OCT was more sensitive (P=0.001) for detection of preperimetric RNFL defects than TD-OCT at a comparable specificity (P=0.227).
CONCLUSIONS
Speckle noise-reduced SD-OCT is better able to detect preperimetric localized RNFL defect(s) than TD-OCT.
目的
评估并比较散斑降噪谱域光学相干断层扫描（SD - OCT；Spectralis OCT）和时域光学相干断层扫描（TD - OCT；Stratus OCT）检测视野检查前开角型青光眼患者局限性视网膜神经纤维层（RNFL）缺损的诊断能力。
方法
使用SD - OCT和TD - OCT对35例有局限性RNFL缺损的视野检查前青光眼患者的35只眼以及72只正常对照眼进行扫描。计算并比较基于各设备内部标准数据库检测局限性RNFL缺损的受试者操作特征曲线下面积（AUROCs）、敏感性和特异性。
结果
SD - OCT最佳参数（颞下象限，AUROC = 0.940）的AUROC显著高于TD - OCT（7点象限，AUROC = 0.881；P = 0.009）。以5%水平为异常标准，SD - OCT参数的敏感性范围为18.9%至83.8%，TD - OCT参数的敏感性范围为5.4%至54.1%。SD - OCT在颞上鼻下颞厚度图5%水平异常时敏感性最高，其特异性为90.3%。基于颞上鼻下颞厚度图，在特异性相当（P = 0.227）的情况下，SD - OCT检测视野检查前RNFL缺损比TD - OCT更敏感（P = 0.001）。
结论
散斑降噪的SD - OCT比TD - OCT更能检测出视野检查前的局限性RNFL缺损。
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