Kim Ko Eun, Yoo Byeong Wook, Jeoung Jin Wook, Park Ki Ho
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea 2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Interdisciplinary Program, Bioengineering Major, Graduate School, Seoul National University, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4857-64. doi: 10.1167/iovs.14-16350.
To investigate the long-term reproducibility of macular ganglion cell analysis in clinically stable glaucoma patients using spectral-domain optical coherence tomography (SD-OCT).
One hundred nine eyes of 109 clinically stable open-angle glaucoma patients with a localized retinal nerve fiber layer (RNFL) defect and a corresponding macular ganglion cell-inner plexiform layer (GCIPL) defect were included in this retrospective, longitudinal study. Clinical stability was defined as showing no change on serial structural (stereo-disc and RNFL photography) and functional (visual field progression analysis) assessments. Three serial SD-OCT (Cirrus-HD) peripapillary and macular scans taken at 6-month intervals were analyzed. Intraclass correlation coefficient (ICC), coefficient of variation (CV), test-retest standard deviation (TRTSD), and tolerance limit of area and angular width of GCIPL defect and GCIPL thickness measurements were assessed.
The ICC of the GCIPL thickness parameters ranged from 0.966 to 0.992, and the CV from 2.0% to 5.5%. The TRTSD was the lowest for the average GCIPL thickness (1.45 μm), the highest for the minimum GCIPL thickness (3.42 μm), and varied from 1.54 to 2.16 μm for the sectoral measurements. The ICC, CV, and TRTSD were 0.993, 3.9%, and 5.32° for angular width, and 0.930, 6.7%, and 0.27 mm2 for area of GCIPL defect. Measurement variances (TRTSD) for the GCIPL measurements showed no significant association with the glaucomatous severity.
The macular GCIPL thickness and deviation maps showed excellent long-term intervisit reproducibility. Macular ganglion cell analysis can be considered as an effective means of monitoring glaucomatous progression in macula.
利用频域光学相干断层扫描（SD-OCT）研究临床稳定的青光眼患者黄斑神经节细胞分析的长期可重复性。
本回顾性纵向研究纳入了109例临床稳定的开角型青光眼患者的109只眼，这些患者存在局限性视网膜神经纤维层（RNFL）缺损及相应的黄斑神经节细胞-内丛状层（GCIPL）缺损。临床稳定性定义为在系列结构（立体视盘和RNFL摄影）和功能（视野进展分析）评估中无变化。分析每隔6个月进行的3次系列SD-OCT（Cirrus-HD）视乳头周围和黄斑扫描。评估组内相关系数（ICC）、变异系数（CV）、重测标准差（TRTSD）以及GCIPL缺损的面积和角宽度及GCIPL厚度测量的公差极限。
GCIPL厚度参数的ICC范围为0.966至0.992，CV为2.0%至5.5%。平均GCIPL厚度的TRTSD最低（1.45μm），最小GCIPL厚度的TRTSD最高（3.42μm），扇形测量的TRTSD在1.54至2.16μm之间变化。GCIPL缺损角宽度的ICC、CV和TRTSD分别为0.993、3.9%和5.32°，面积的ICC、CV和TRTSD分别为0.930、6.7%和0.27mm²。GCIPL测量的测量方差（TRTSD）与青光眼严重程度无显著关联。
黄斑GCIPL厚度和偏差图显示出优异的长期随访间可重复性。黄斑神经节细胞分析可被视为监测黄斑区青光眼进展的有效手段。
