利用频域光学相干断层扫描检测青光眼进展。
Detection of glaucomatous progression by spectral-domain optical coherence tomography.
机构信息
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
出版信息
Ophthalmology. 2013 Jul;120(7):1388-95. doi: 10.1016/j.ophtha.2012.12.014. Epub 2013 Mar 6.
PURPOSE
To compare the rate of change of circumpapillary retinal nerve fiber layer (cRNFL) thickness, macular volume and thickness, and optic nerve head (ONH) parameters assessed using spectral-domain optical coherence tomography (SD-OCT) between eyes with progressing and nonprogressing glaucoma.
DESIGN
Longitudinal, observational study.
PARTICIPANTS
Two hundred seventy-nine eyes from 162 glaucoma patients followed for an average of 2.2 years.
METHODS
Eyes were classified as progressors and nonprogressors according to assessment of optic disc and RNFL photographs and visual field progression analysis. Linear mixed effects models were used to evaluate the overall rate of change of cRNFL thickness, macular volume and thickness, and ONH parameters after adjustment for age, spherical equivalent, signal strength, and baseline SD-OCT measurements.
MAIN OUTCOME MEASURES
The rate of change of cRNFL thickness, macular volume, and thickness and ONH parameters.
RESULTS
Sixty-three eyes (22.6%) from 52 subjects were identified as progressors. Average, inferior quadrant, and 6- and 7-o'clock sector cRNFL thickness decreased faster in progressors than in nonprogressors (-1.26 vs -0.94, -2.47 vs -1.75, -3.60 vs -2.52, and -2.77 vs -1.51 μm/year, respectively; all P<0.05). The ONH rim area decreased faster, and average and vertical cup-to-disc ratio increased faster in progressors than in nonprogressors (-0.016 vs -0.006 mm(2)/year, and 0.004 vs 0.002 and 0.006 vs 0.004 per year, respectively; all P<0.05). Macular cube volume and the thickness of temporal outer and inferior inner macular sectors decreased faster in progressors than in nonprogressors (-0.068 vs -0.048 mm(3)/year, and -2.27 vs -1.67 and -2.51 vs -1.73 μm/year, respectively; all P<0.05).
CONCLUSIONS
Serial measurement of parameters in all 3 areas (cRNFL, macula, and ONH) by SD-OCT may permit identification of progression in glaucomatous eyes.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
目的
比较使用谱域光学相干断层扫描（SD-OCT）评估的进展性和非进展性青光眼眼中的环周视网膜神经纤维层（cRNFL）厚度、黄斑体积和厚度以及视盘参数的变化率。
设计
纵向观察性研究。
参与者
162 例青光眼患者的 279 只眼，平均随访 2.2 年。
方法
根据视盘和 RNFL 照片评估和视野进展分析，将眼分为进展性和非进展性。使用线性混合效应模型，在调整年龄、等效球镜、信号强度和基线 SD-OCT 测量值后，评估 cRNFL 厚度、黄斑体积和厚度以及视盘参数的总体变化率。
主要观察指标
cRNFL 厚度、黄斑体积和厚度以及视盘参数的变化率。
结果
52 名受试者中有 63 只眼（22.6%）被确定为进展性。进展组的平均、下象限和 6 点和 7 点扇形 cRNFL 厚度比非进展组下降更快（-1.26 对-0.94、-2.47 对-1.75、-3.60 对-2.52 和-2.77 对-1.51μm/年，均 P<0.05）。进展组的视盘边缘面积下降更快，平均和垂直杯盘比增加更快（-0.016 对-0.006mm2/年，0.004 对 0.002 和 0.006 对 0.004 年，均 P<0.05）。进展组的黄斑立方体积和颞外侧和下内侧黄斑区厚度下降更快（-0.068 对-0.048mm3/年，-2.27 对-1.67 和-2.51 对-1.73μm/年，均 P<0.05）。
结论
SD-OCT 对所有 3 个区域（cRNFL、黄斑和视盘）的参数进行连续测量，可能有助于识别青光眼眼的进展。
金融披露
作者在本文讨论的任何材料中均无专有或商业利益。
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