扫描质量对频域光学相干断层扫描诊断青光眼准确性的影响。

Effect of scan quality on diagnostic accuracy of spectral-domain optical coherence tomography in glaucoma.

机构信息

Vazir Sultan Tobacco (VST) Glaucoma Center, L. V. Prasad Eye Institute, Banjara Hills, Hyderabad, India; Center for Clinical Epidemiology and Biostatistics, L. V. Prasad Eye Institute, Banjara Hills, Hyderabad, India.

Vazir Sultan Tobacco (VST) Glaucoma Center, L. V. Prasad Eye Institute, Banjara Hills, Hyderabad, India.

出版信息

Am J Ophthalmol. 2014 Mar;157(3):719-27.e1. doi: 10.1016/j.ajo.2013.12.012. Epub 2013 Dec 15.

DOI:10.1016/j.ajo.2013.12.012

PMID:24345321

Abstract

PURPOSE

To evaluate the effect of scan quality on the diagnostic accuracies of optic nerve head (ONH), retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) parameters of spectral-domain optical coherence tomography (SD OCT) in glaucoma.

DESIGN

Cross-sectional study.

METHODS

Two hundred fifty-two eyes of 183 control subjects (mean deviation [MD]: -1.84 dB) and 207 eyes of 159 glaucoma patients (MD: -7.31 dB) underwent ONH, RNFL, and GCC scanning with SD OCT. Scan quality of SD OCT images was based on signal strength index (SSI) values. Influence of SSI on diagnostic accuracy of SD OCT was evaluated by receiver operating characteristic (ROC) regression.

RESULTS

Diagnostic accuracies of all SD OCT parameters were better when the SSI values were higher. This effect was statistically significant (P < .05) for ONH and RNFL but not for GCC parameters. In mild glaucoma (MD of -5 dB), area under ROC curve (AUC) for rim area, average RNFL thickness, and average GCC thickness parameters improved from 0.651, 0.678, and 0.726, respectively, at an SSI value of 30 to 0.873, 0.962, and 0.886, respectively, at an SSI of 70. AUCs of the same parameters in advanced glaucoma (MD of -15 dB) improved from 0.747, 0.890, and 0.873, respectively, at an SSI value of 30 to 0.922, 0.994, and 0.959, respectively, at an SSI of 70.

CONCLUSION

Diagnostic accuracies of SD OCT parameters in glaucoma were significantly influenced by the scan quality even when the SSI values were within the manufacturer-recommended limits. These results should be considered while interpreting the SD OCT scans for glaucoma.

摘要

目的

评估扫描质量对青光眼患者的光学相干断层扫描（SD OCT）视神经头（ONH）、视网膜神经纤维层（RNFL）和节细胞复合体（GCC）参数的诊断准确性的影响。

设计

横断面研究。

方法

对 183 例对照受试者（平均偏差[MD]：-1.84dB）的 252 只眼和 159 例青光眼患者（MD：-7.31dB）的 207 只眼进行了 SD OCT 的 ONH、RNFL 和 GCC 扫描。SD OCT 图像的扫描质量基于信号强度指数（SSI）值。通过接收者操作特性（ROC）回归评估 SSI 对 SD OCT 诊断准确性的影响。

结果

当 SSI 值较高时，所有 SD OCT 参数的诊断准确性都更好。这种影响在统计学上是显著的（P<.05），对于 ONH 和 RNFL，但对于 GCC 参数则不然。在轻度青光眼（MD 为-5dB）中，边缘区域、平均 RNFL 厚度和平均 GCC 厚度参数的 ROC 曲线下面积（AUC）从 SSI 值为 30 时的 0.651、0.678 和 0.726 分别提高到 SSI 值为 70 时的 0.873、0.962 和 0.886。在晚期青光眼（MD 为-15dB）中，相同参数的 AUC 从 SSI 值为 30 时的 0.747、0.890 和 0.873 分别提高到 SSI 值为 70 时的 0.922、0.994 和 0.959。