Nakanishi Hideo, Akagi Tadamichi, Hangai Masanori, Kimura Yugo, Suda Kenji, Kumagai Kyoko Kawashima, Morooka Satoshi, Ikeda Hanako Ohashi, Yoshimura Nagahisa
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan,
Graefes Arch Clin Exp Ophthalmol. 2015 Jul;253(7):1143-52. doi: 10.1007/s00417-015-3026-y. Epub 2015 May 6.
We aimed to determine the sensitivity and specificity of the normative database of non-myopic and highly myopic eyes of the macular ganglion cell complex (mGCC) thickness embedded in the NIDEK RS-3000 spectral-domain optical coherence tomography (SD-OCT) for detecting early glaucoma in highly myopic eyes.
Forty-seven highly myopic eyes (axial length ≥26.0 mm) of 47 subjects were studied. The SD-OCT images were used to determine the mGCC thickness within a 9-mm diameter circle centered on the fovea. The sensitivity and specificity of the non-myopic database were compared to that of the highly myopic database for distinguishing the early glaucomatous eyes from the non-glaucomatous eyes. The mGCC scans were classified as abnormal if at least one of the eight sectors of the significance map was < 1 % of the normative thickness.
Twenty-one eyes were diagnosed to be non-glaucomatous and 26 eyes to have early glaucoma. . The average mGCC thickness was significantly thinner (80.9 ± 8.5 μm) in the early glaucoma group than in the non-glaucomatous group (91.2 ± 7.5 μm; p <1 × 10(-4)). The sensitivity was 96.2 % and specificity was 47.6 % when the non-myopic database was used, and the sensitivity was 92.3 % and the specificity was 90.5 % when the highly myopic database was used. The difference in the specificity was significant (p < 0.01).
The significantly higher specificity of the myopic normative database for detecting early glaucoma in highly myopic eyes will lead to fewer false positive diagnoses. The database obtained from highly myopic eyes should be used when evaluating the mGCC thickness of highly myopic eyes.
我们旨在确定NIDEK RS - 3000光谱域光学相干断层扫描（SD - OCT）中黄斑神经节细胞复合体（mGCC）厚度的非近视和高度近视眼睛的标准数据库对检测高度近视眼中早期青光眼的敏感性和特异性。
对47名受试者的47只高度近视眼睛（眼轴长度≥26.0 mm）进行研究。使用SD - OCT图像确定以黄斑中心凹为中心、直径9 mm的圆内的mGCC厚度。比较非近视数据库和高度近视数据库区分早期青光眼眼睛和非青光眼眼睛的敏感性和特异性。如果显著性图的八个扇区中至少有一个小于标准厚度的1%，则将mGCC扫描分类为异常。
21只眼睛被诊断为非青光眼，26只眼睛患有早期青光眼。早期青光眼组的平均mGCC厚度（80.9±8.5μm）明显薄于非青光眼组（91.2±7.5μm；p<1×10⁻⁴）。使用非近视数据库时，敏感性为96.2%，特异性为47.6%；使用高度近视数据库时，敏感性为92.3%，特异性为90.5%。特异性差异具有显著性（p<0.01）。
近视标准数据库在检测高度近视眼中早期青光眼时具有显著更高的特异性，这将减少假阳性诊断。在评估高度近视眼睛的mGCC厚度时，应使用从高度近视眼睛获得的数据库。
