Kang Eun Min, Hong Samin, Kim Chan Yun, Seong Gong Je
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2015 Aug;29(4):263-9. doi: 10.3341/kjo.2015.29.4.263. Epub 2015 Jul 21.
Though there are many reports regarding the structure-function relationship in glaucoma, they are too complicated to apply to the routine clinical setting. The aim of this study was to investigate the direct relationship between peripapillary retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and visual field (VF) severity indices computed by standard automated perimetry.
This cross-sectional comparative study included 104 glaucomatous patients and 59 healthy subjects. Peripapillary RNFL thickness was measured by spectral domain (SD) and time domain (TD) OCTs. Four glaucoma VF severity indices, including mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) VF score, and Advanced Glaucoma Intervention Study (AGIS) VF score, were calculated using standard automated perimetry. The Pearson's correlation coefficients (r) between the average and quadrants of peripapillary RNFL thicknesses and the four VF severity indices were calculated.
In glaucomatous eyes, the r value between the average RNFL thickness measured by SD OCT and each VF severity index were 0.562, -0.514, -0.577, and -0.567 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Among each quadrant, the inferior RNFL thickness showed the largest r value; 0.587, -0.552, -0.613, and -0.598 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Measurements by TD OCT showed similar strengths of association with SD OCT.
Moderate correlation was identified between peripapillary RNFL thicknesses measured by SD/TD OCT and glaucoma VF severity indices. Among each quadrant, the inferior RNFL thickness showed the greatest association with glaucoma VF severity indices. There was no significant difference according to the type of VF severity index or the type of OCTs.
虽然有许多关于青光眼结构 - 功能关系的报道,但它们过于复杂,难以应用于常规临床环境。本研究的目的是调查光学相干断层扫描(OCT)测量的视乳头周围视网膜神经纤维层(RNFL)厚度与标准自动视野计计算的视野(VF)严重程度指标之间的直接关系。
这项横断面比较研究包括104例青光眼患者和59名健康受试者。通过光谱域(SD)和时域(TD)OCT测量视乳头周围RNFL厚度。使用标准自动视野计计算四个青光眼VF严重程度指标,包括平均偏差(MD)、模式标准差(PSD)、协作初始青光眼治疗研究(CIGTS)VF评分和晚期青光眼干预研究(AGIS)VF评分。计算视乳头周围RNFL厚度的平均值和象限与四个VF严重程度指标之间的Pearson相关系数(r)。
在青光眼眼中,SD OCT测量的平均RNFL厚度与每个VF严重程度指标之间的r值,MD为0.562,PSD为 - 0.514,CIGTS VF评分为 - 0.577,AGIS VF评分为 - 0.567(所有p < 0.001)。在每个象限中,下方RNFL厚度显示出最大的r值;MD为0.587,PSD为 - 0.552,CIGTS VF评分为 - 0.613,AGIS VF评分为 - 0.598(所有p < 0.001)。TD OCT测量显示与SD OCT有相似的关联强度。
通过SD/TD OCT测量的视乳头周围RNFL厚度与青光眼VF严重程度指标之间存在中度相关性。在每个象限中,下方RNFL厚度与青光眼VF严重程度指标的关联最大。根据VF严重程度指标的类型或OCT的类型,没有显著差异。