Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan.
BMC Ophthalmol. 2014 Oct 4;14:118. doi: 10.1186/1471-2415-14-118.
To evaluate the use of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and visual field (VF) measurements in detecting disease progression in patients with early glaucoma.
Over a 3-year period, this study examined 60 eyes of 39 glaucoma patients whose total deviation in the superior or inferior hemifield was more than -6 dB. All eyes underwent at least four serial RNFL measurements performed by Cirrus OCT, with the first and last measurements separated by at least three years. On the same day as the RNFL imaging, VF testing was also performed by using the Swedish Interactive Threshold Algorithm Standard 30-2 program of the Humphrey Field Analyzer. Serial RNFL thicknesses and VF progression were assessed using the Guided Progression Analysis (GPA) software program. RNFL thickness progression and VF progression were evaluated by the event analysis.
The mean observation period was 57.6 ± 10.0 months, and during this time, a total of 366 OCT and 366 VF measurements were performed. Using only OCT, progression was found in 2 eyes, while progression was found in 1 eye when only using VF GPA. When combined measurement findings were used, the analysis found progression in 8 eyes.
When mild VF defect is present, OCT RNFL thickness measurements can be helpful in discerning glaucoma progression.
评估光学相干断层扫描（OCT）视网膜神经纤维层（RNFL）厚度和视野（VF）测量在检测早期青光眼患者疾病进展中的作用。
在 3 年的时间里，本研究检查了 39 名青光眼患者的 60 只眼睛，这些患者的上或下半视野的总偏差大于-6dB。所有眼睛均至少进行了 4 次由 Cirrus OCT 进行的连续 RNFL 测量，第一次和最后一次测量至少相隔 3 年。在进行 RNFL 成像的同一天，还使用 Humphrey 视野分析仪的瑞典互动阈值算法标准 30-2 程序进行了 VF 测试。使用 Guided Progression Analysis（GPA）软件程序评估了连续的 RNFL 厚度和 VF 进展情况。通过事件分析评估了 RNFL 厚度进展和 VF 进展。
平均观察期为 57.6±10.0 个月，在此期间共进行了 366 次 OCT 和 366 次 VF 测量。仅使用 OCT，发现 2 只眼睛有进展，而仅使用 VF GPA 则发现 1 只眼睛有进展。当结合测量结果进行分析时，发现 8 只眼睛有进展。
当存在轻度 VF 缺陷时，OCT RNFL 厚度测量有助于辨别青光眼进展。
