Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Palm Beach Gardens, FL, USA.
Eye (Lond). 2013 Oct;27(10):1180-7. doi: 10.1038/eye.2013.163. Epub 2013 Aug 2.
To examine the impact of manual vs automated disc margin delineation on optic nerve head (ONH) and retinal nerve fiber layer (RNFL) parameters using spectral-domain optical coherence tomography (SDOCT).
A prospective cohort study consisting of normal, glaucoma suspect (GS) and glaucoma patients who underwent ONH and RNFL measurements using SDOCT technology (RTVue; Optovue Inc.). The retinal pigment epithelium/Bruch's membrane (RPE/BM) complex end points were automatically determined first, and were manually redefined subsequently. Analysis of variance, coefficient of variation (COV), concordance correlation coefficient (CCC), and Bland-Altman plots were used for the analyses.
Ninety-nine eyes of 50 subjects (age 68±10 years) consisting of 36 glaucoma, 56 GS, and 7 normal eyes were included. The RNFL thickness measurements were similar (P>0.05) between the two methods of demarcation, except for the inferior-nasal sector (P=0.04). For the ONH measurements, the cup-to-disc (C/D) ratio and rim area showed significant differences between the two methods (P<0.001). COV/CCC values for the ONH parameters were as follows: cup area 17.6%/0.88; cup volume 7.4%/0.91; average C/D ratio 18.1%/0.78; rim area 25.3%/0.69; and rim volume 42.6%/0.71, respectively. CCC/COV values for the RNFL parameters were as follows: average 2.1%/0.98; inferior-temporal quadrant 8.1%/0.79; inferior-nasal quadrant INQ quadrant 12.6%/0.67; SNQ quadrant 7.8%/0.83; and STQ quadrant 7.8%/0.88, respectively.
An overall high agreement and moderate-substantial concordance was observed between the demarcation methods. Automated disc margin delineation of SDOCT can be used reliably in clinical practice.
使用频域光学相干断层扫描（SDOCT）检查手动与自动视盘边缘描绘对视神经头（ONH）和视网膜神经纤维层（RNFL）参数的影响。
前瞻性队列研究包括接受 SDOCT 技术（RTVue； Optovue Inc.）进行 ONH 和 RNFL 测量的正常、青光眼疑似（GS）和青光眼患者。首先自动确定视网膜色素上皮/布鲁赫膜（RPE/BM）复合终点，然后手动重新定义。使用方差分析、变异系数（COV）、一致性相关系数（CCC）和 Bland-Altman 图进行分析。
纳入 50 名受试者（年龄 68±10 岁）的 99 只眼，包括 36 只青光眼、56 只 GS 和 7 只正常眼。两种描绘方法的 RNFL 厚度测量值相似（P>0.05），除了下鼻象限（P=0.04）。对于 ONH 测量，两种方法之间杯盘比（C/D）和边缘面积有显著差异（P<0.001）。ONH 参数的 COV/CCC 值如下：杯面积 17.6%/0.88；杯容积 7.4%/0.91；平均 C/D 比 18.1%/0.78；边缘面积 25.3%/0.69；边缘容积 42.6%/0.71。RNFL 参数的 CCC/COV 值如下：平均 2.1%/0.98；下颞象限 8.1%/0.79；下鼻象限 INQ 象限 12.6%/0.67；SNQ 象限 7.8%/0.83；和 STQ 象限 7.8%/0.88。
两种描绘方法之间观察到总体高度一致和中度实质性一致。SDOCT 的自动视盘边缘描绘可在临床实践中可靠使用。
