Tan Ou, Liu Liang, Zhang Xinbo, Morrison John C, Huang David
Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT438-43. doi: 10.1167/iovs.15-18911.
We investigated the feasibility of glaucoma detection by measuring retinal surface contour variability (RSCV) using optical coherence tomography (OCT).
The peripapillary region in one eye of each participant was scanned over an 8 × 8 mm area with a swept source OCT prototype. The retinal surface contour was sampled at approximately 1.5- to 3.5-mm radius circles centered on the optic nerve head. The RSCV is defined as the average log value within a middle spatial frequency band of the Fourier transform to the elevation profile of the inner retinal surface. The spatial frequency band was optimized to distinguish glaucoma from normal. Nerve fiber layer thickness (NFLT) was sampled around a 1.7-mm radius circle. Glaucoma severity was assessed by automated static perimetry.
We enrolled 17 glaucomatous eyes and 17 healthy eyes. A great majority of the glaucoma group were in the early stage (visual field mean deviation average -2.48 ± 3.73 dB). Significant differences were found for RSCV between glaucoma and control eyes (P < 0.003) at all radii. The area under the receiver operating characteristic curve (AROC = 0.90) of RSCV was best at the 3.5-mm radius. This was not significantly better than NFLT (AROC = 0.84). With the 99% specificity, the glaucoma detection sensitivity was 53% for RSCV and 29% for NFLT (P = 0.13).
Retinal surface contour variability was significantly increased in glaucoma patients. The diagnostic accuracy of RSCV was equal to NFLT in early glaucoma. Since the RSCV detects small-scale focal damage and the average NFLT measures global damage, they provide different diagnostic information that may be synergistic.
我们研究了使用光学相干断层扫描（OCT）测量视网膜表面轮廓变异性（RSCV）来检测青光眼的可行性。
使用扫频源OCT原型对每位参与者一只眼睛的视乳头周围区域进行8×8mm区域的扫描。在以视神经乳头为中心、半径约1.5至3.5mm的圆周上对视网膜表面轮廓进行采样。RSCV定义为傅里叶变换到视网膜内表面高度轮廓的中间空间频率带内的平均对数值。对空间频率带进行了优化，以区分青光眼和正常情况。在半径为1.7mm的圆周周围采样神经纤维层厚度（NFLT）。通过自动静态视野检查评估青光眼严重程度。
我们纳入了17只青光眼患眼和17只健康眼。青光眼组大多数处于早期阶段（视野平均偏差平均值为-2.48±3.73dB）。在所有半径处，青光眼患眼与对照眼之间的RSCV均存在显著差异（P<0.003）。RSCV的受试者操作特征曲线下面积（AROC=0.90）在半径为3.5mm时最佳。这并不显著优于NFLT（AROC=0.84）。在特异性为99%时，RSCV检测青光眼的灵敏度为53%，NFLT为29%（P=0.13）。
青光眼患者的视网膜表面轮廓变异性显著增加。在早期青光眼中，RSCV的诊断准确性与NFLT相当。由于RSCV检测小规模局灶性损伤，而平均NFLT测量整体损伤，它们提供了可能具有协同作用的不同诊断信息。
