Ramachandran Rithambara, Zhou Lisa, Locke Kirsten G, Birch David G, Hood Donald C
Department of Psychology, Columbia University, New York, NY.
Retina Foundation of the Southwest, Dallas, TX.
Transl Vis Sci Technol. 2013 Nov;2(7):5. doi: 10.1167/tvst.2.7.5. Epub 2013 Nov 11.
To compare the efficacy of frequency domain optical coherence tomography (fdOCT)-derived outer retinal measures in tracking disease progression in x-linked (xl) retinitis pigmentosa (RP) patients.
Macular volume scans and line scans (Spectralis) were obtained from 27 xlRP patients (15.3 ± 6.4 years) at two visits approximately 2 years apart. Changes in average outer retinal layer thicknesses across the volume scan were compared to changes detected by measures derived from the edge of the inner segment ellipsoid zone (EZ) band, that is, where the EZ band (also known as inner segment/outer segment border) disappears. Repeatability was tested on an independent set of 18 RP patients (43.5 ± 18.0 years).
Average outer segment (OS) and outer nuclear layer (ONL) thickness showed marginally significant annual changes ( < 0.05), while total receptor (TR) thickness showed a greater change ( < 0.01). All measures derived from the edge of the EZ band significantly decreased ( < 0.01). Mean ± SD for test-retest differences in horizontal widths was 0.01 ± 0.06 mm.
Measures of the EZ band are more effective in detecting disease progression than are thickness measures. Given the similar effectiveness of line and volume scans, manually marking the EZ band edge on vertical and/or horizontal line scans can be useful in tracking progression.
Because disease progression in RP can be relatively slow, annual changes can be difficult to monitor during the course of a clinical trial. Here we suggest a quick, effective, and reliable method for detecting subtle changes.
比较频域光学相干断层扫描（fdOCT）得出的外层视网膜测量值在追踪X连锁（XL）视网膜色素变性（RP）患者疾病进展方面的疗效。
对27例XL RP患者（15.3±6.4岁）进行了两次黄斑容积扫描和线扫描（Spectralis），两次检查间隔约2年。将容积扫描中平均外层视网膜层厚度的变化与从内节椭圆体带（EZ）边缘得出的测量值检测到的变化进行比较，即EZ带（也称为内节/外节边界）消失的位置。在一组独立的18例RP患者（43.5±18.0岁）中测试了重复性。
平均外节（OS）和外核层（ONL）厚度显示出每年略有显著变化（<0.05），而总感受器（TR）厚度变化更大（<0.01）。从EZ带边缘得出的所有测量值均显著降低（<0.01）。重测水平宽度差异的均值±标准差为0.01±0.06mm。
EZ带测量在检测疾病进展方面比厚度测量更有效。鉴于线扫描和容积扫描效果相似，在垂直和/或水平线上手动标记EZ带边缘有助于追踪疾病进展。
由于RP疾病进展可能相对缓慢，在临床试验过程中，年度变化可能难以监测。在此，我们提出一种快速、有效且可靠的方法来检测细微变化。
