Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea.
Eye (Lond). 2013 Sep;27(9):1022-31. doi: 10.1038/eye.2013.119. Epub 2013 Jun 7.
To evaluate and compare the diagnostic ability of spectral domain optical coherence tomography (SD-OCT) for detecting localized retinal nerve fiber layer (RNFL) defects in topographic RNFL maps and circumpapillary RNFL (cpRNFL) thickness measurements.
Sixty-four eyes with localized RNFL defects in red-free RNFL photographs and 72 healthy eyes were included. All participants were imaged with SD-OCT. The area and angular width of the localized RNFL defects were measured with ImageJ software on RNFL thickness map, significance map (yellow pixels, <5% level), and red-free RNFL photographs. The sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs) were calculated for cpRNFL thickness, macular inner retina thickness, and RNFL maps (thickness, significance) according to the quantitative measurements and a <5% level of classification to distinguish eyes with localized RNFL defects from healthy eyes.
RNFL thickness map (sensitivity 96.9-98.4%, specificity 86.1-98.6%, and AUCs 0.915-0.992) and significance map (sensitivity 96.9-98.4%, specificity 88.9-95.8%, and AUCs 0.937-0.983) showed superior performance in detecting localized RNFL defects compared with other parameters (P-value 0.001-0.024) except for 36 sector cpRNFL thickness (sensitivity 92.2%, specificity 87.5%, and AUCs 0.898; P-value 0.080-0.545). The sensitivity for detecting RNFL defects was related to the angular width, area, and depth of the RNFL defects in the cpRNFL (4 sector, 12 sector) and macular inner retinal measurements. RNFL thickness and significance maps showed a constant sensitivity regardless of variations in angular width, area, and depth of the RNFL defects.
RNFL thickness and significance maps could be used to distinguish eyes with localized RNFL defects from healthy eyes more effectively than cpRNFL thickness and macular inner retina thickness measurements.
评估并比较谱域光相干断层扫描（SD-OCT）在检测局部视网膜神经纤维层（RNFL）缺陷的方位 RNFL 图和环周 RNFL（cpRNFL）厚度测量中的诊断能力。
纳入 64 只在无赤光 RNFL 照片中存在局部 RNFL 缺陷的眼和 72 只健康眼。所有参与者均接受 SD-OCT 成像。使用 ImageJ 软件在 RNFL 厚度图、显著性图（黄色像素，<5%水平）和无赤光 RNFL 照片上测量局部 RNFL 缺陷的面积和角宽度。根据定量测量和<5%的分类水平，计算 cpRNFL 厚度、黄斑内视网膜厚度和 RNFL 图（厚度、显著性）的敏感性、特异性和受试者工作特征曲线下面积（AUCs），以区分存在局部 RNFL 缺陷的眼和健康眼。
RNFL 厚度图（敏感性 96.9-98.4%，特异性 86.1-98.6%，AUCs 0.915-0.992）和显著性图（敏感性 96.9-98.4%，特异性 88.9-95.8%，AUCs 0.937-0.983）在检测局部 RNFL 缺陷方面的性能优于其他参数（P 值 0.001-0.024），但 36 分区 cpRNFL 厚度除外（敏感性 92.2%，特异性 87.5%，AUCs 0.898；P 值 0.080-0.545）。检测 RNFL 缺陷的敏感性与 cpRNFL（4 分区、12 分区）和黄斑内视网膜测量中的 RNFL 缺陷的角宽度、面积和深度有关。RNFL 厚度和显著性图无论 RNFL 缺陷的角宽度、面积和深度如何变化，其敏感性均保持不变。
与 cpRNFL 厚度和黄斑内视网膜厚度测量相比，RNFL 厚度和显著性图可更有效地将存在局部 RNFL 缺陷的眼与健康眼区分开来。
