光学相干断层扫描参数对不同类型视盘损伤早期青光眼的诊断准确性。
Glaucoma diagnostic accuracy of optical coherence tomography parameters in early glaucoma with different types of optic disc damage.
机构信息
Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
出版信息
Ophthalmology. 2014 Oct;121(10):1990-7. doi: 10.1016/j.ophtha.2014.04.030. Epub 2014 Jun 14.
PURPOSE
To compare the initial visual field (VF) defect pattern and the spectral-domain optical coherence tomography (OCT) parameters and investigate the effects of distinct types of optic disc damage on the diagnostic performance of these OCT parameters in early glaucoma.
DESIGN
Retrospective, observational study.
PARTICIPANTS
A total of 138 control eyes and 160 eyes with early glaucoma were enrolled. The glaucomatous eyes were subdivided into 4 groups according to the type of optic disc damage: focal ischemic (FI) group, myopic (MY) group, senile sclerotic (SS) group, and generalized enlargement (GE) group.
METHODS
The values of total deviation (TD) maps were analyzed, and superior-inferior (S-I) differences of TD were calculated. The optic nerve head (ONH) parameters, peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured.
MAIN OUTCOME MEASURES
Comparison of diagnostic ability using area under the receiver operating characteristic curves (AUCs).
RESULTS
The S-I and central S-I difference of the FI group were larger than those of the GE group. The rim area of the SS group was larger than those of the 3 other groups, and the vertical cup-to-disc ratio (CDR) of the GE group was larger than that of the MY group. In addition, the minimum and inferotemporal GCIPL thicknesses of the FI group were smaller than those of the GE group. The AUC of the rim area (0.89) was lower than that of the minimum GCIPL (0.99) in the SS group, and the AUC of the vertical CDR (0.90) was lower than that of the minimum GCIPL (0.99) in the MY group. Furthermore, the AUCs of the minimum GCIPL thicknesses of the FI and MY group were greater than those of the average pRNFL thickness for detecting glaucoma, as opposed to the SS and GE.
CONCLUSIONS
The OCT parameters differed among the 4 groups on the basis of the distinct optic disc appearance and initial glaucomatous damage pattern. Clinicians should be aware that the diagnostic capability of OCT parameters could differ according to the type of optic disc damage in early glaucoma.
目的
比较初始视野（VF）缺损模式和光谱域光相干断层扫描（OCT）参数，并探讨不同类型视盘损伤对视盘 OCT 参数在早期青光眼诊断中的影响。
设计
回顾性、观察性研究。
参与者
共纳入 138 只正常对照眼和 160 只早期青光眼眼。根据视盘损伤类型，将青光眼眼分为 4 组：局灶缺血（FI）组、近视（MY）组、老年硬化（SS）组和弥漫性扩大（GE）组。
方法
分析总偏差（TD）图的数值，并计算 TD 的上下差异。测量视神经头（ONH）参数、视盘周围视网膜神经纤维层（pRNFL）和节细胞内丛状层（GCIPL）厚度。
主要观察指标
使用受试者工作特征曲线下面积（AUC）比较诊断能力。
结果
FI 组的上下和中央上下差异大于 GE 组。SS 组的边缘面积大于其他 3 组，GE 组的垂直杯盘比（CDR）大于 MY 组。此外，FI 组的最小和下颞 GCIPL 厚度小于 GE 组。SS 组的边缘面积（0.89）的 AUC 低于最小 GCIPL（0.99），MY 组的垂直 CDR（0.90）的 AUC 低于最小 GCIPL（0.99）。此外，FI 和 MY 组的最小 GCIPL 厚度的 AUC 大于平均 pRNFL 厚度用于检测青光眼，而 SS 和 GE 组则相反。
结论
根据不同的视盘外观和初始青光眼损伤模式，4 组之间的 OCT 参数存在差异。临床医生应意识到，在早期青光眼患者中，OCT 参数的诊断能力可能因视盘损伤类型而异。
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