Tenkumo Kaori, Hirooka Kazuyuki, Baba Tetsuya, Nitta Eri, Sato Shino, Shiraga Fumio
Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
Jpn J Ophthalmol. 2013 Sep;57(5):451-6. doi: 10.1007/s10384-013-0254-8. Epub 2013 Jun 25.
To evaluate the capability of optical coherence tomography (OCT), retinal nerve fiber layer (RNFL) thickness, and visual field (VF) measurements in glaucoma progression detection.
The study examined 62 eyes of 37 glaucoma patients observed over a 3-year period. All eyes underwent at least four serial RNFL measurements performed by Cirrus OCT, with the first and last measurements separated by at least 3 years. VF testing was performed by using the Swedish interactive threshold algorithm (SITA) Standard 30-2 program of the Humphrey field analyzer (HFA) on the same day as the RNFL imaging. Both serial RNFL thicknesses and VF progression were assessed by the guided progression analysis (GPA) software program. RNFL thickness progression was evaluated by event analysis. Total deviation (TD) in the superior or inferior hemifield was also examined.
A total of 295 OCT scans and 295 VFs were analyzed. Five eyes exhibited progression by OCT only and 8 eyes exhibited progression by VF GPA only. When the analysis was based on the combined measurement findings, progression was noted in 6 eyes. The average of the progressive hemifield TD at baseline for combined RNFL and VF progression was -3.21±1.38 dB, while it was -2.17±1.14 dB for RNFL progression and -9.12±3.75 dB for VF progression. The average of the progressive hemifield TD indicated a significant advancement of VF progression as compared to RNFL progression (P=0.002).
When a mild VF defect is present, OCT RNFL thickness measurements are important in helping discern glaucoma progression.
评估光学相干断层扫描（OCT）、视网膜神经纤维层（RNFL）厚度测量及视野（VF）检测在青光眼病情进展监测中的能力。
本研究对37例青光眼患者的62只眼睛进行了为期3年的观察。所有眼睛均接受了至少4次由Cirrus OCT进行的连续RNFL测量，首次和末次测量间隔至少3年。在进行RNFL成像的同一天，使用Humphrey视野分析仪（HFA）的瑞典交互式阈值算法（SITA）标准30 - 2程序进行VF检测。通过引导进展分析（GPA）软件程序评估连续RNFL厚度和VF进展情况。通过事件分析评估RNFL厚度进展。还检查了上半视野或下半视野的总偏差（TD）。
共分析了295次OCT扫描和295次VF检测结果。5只眼睛仅通过OCT显示有进展，8只眼睛仅通过VF GPA显示有进展。基于联合测量结果进行分析时，6只眼睛有进展。联合RNFL和VF进展时，进展性半视野TD在基线时的平均值为-3.21±1.38 dB，RNFL进展时为-2.17±1.14 dB，VF进展时为-9.12±3.75 dB。进展性半视野TD的平均值表明，与RNFL进展相比，VF进展有显著进展（P = 0.002）。
当存在轻度VF缺陷时，OCT RNFL厚度测量对于鉴别青光眼进展很重要。
