Lee Eun Ji, Lee Kyoung Min, Kim Hyunjoong, Kim Tae-Woo
Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea.
Invest Ophthalmol Vis Sci. 2016 Aug 1;57(10):4194-204. doi: 10.1167/iovs.16-19578.
To compare the diagnostic ability of the new spectral-domain optical coherence tomography (SD-OCT) algorithm for measuring circumpapillary retinal nerve fiber layer (RNFL) thickness centered on Bruch's membrane opening (BMO), with the conventional circumpapillary RNFL thickness measurement centered on the optic disc.
In 75 eyes with primary open-angle glaucoma (POAG) and 71 healthy control eyes, circumpapillary RNFL thickness was measured with SD-OCT, first by centering the scan circle on the optic disc (RNFLDi), and then on the BMO (RNFLBMO). Difference between the topographic profiles of RNFLDi and RNFLBMO was compared and factors influencing any discrepancies between methods were investigated. Glaucoma diagnostic abilities of each method were assessed using the areas under receiver operating characteristic curve (AUCs).
Axial length did not differ between POAG and healthy eyes. A longer axial length and larger width of externally oblique border tissue (BT) associated with tilted optic disc were the two major factors influencing discrepancies between RNFLBMO and RNFLDi (both P < 0.001). Compared with RNFLBMO, RNFLDi tended to result in a thinner nasal RNFL in eyes with externally oblique BT, while RNFLBMO and RNFLDi were comparable in eyes without externally oblique BT. The glaucoma diagnostic capabilities were generally comparable, but RNFLBMO was superior to RNFLDi in eyes having a larger width (>250 μm) of externally oblique BT (AUC = 0.933 vs. 0.843, respectively, P = 0.027).
The new circumpapillary RNFL scanning algorithm centered on BMO may provide a more reliable RNFL profile in eyes with tilted optic discs, with a largely comparable glaucoma diagnostic ability to the conventional algorithm.
比较用于测量以布鲁赫膜开口（BMO）为中心的视乳头周围视网膜神经纤维层（RNFL）厚度的新型光谱域光学相干断层扫描（SD - OCT）算法与以视盘为中心的传统视乳头周围RNFL厚度测量方法的诊断能力。
对75只原发性开角型青光眼（POAG）患眼和71只健康对照眼，使用SD - OCT测量视乳头周围RNFL厚度，首先将扫描圈中心对准视盘（RNFLDi），然后对准BMO（RNFLBMO）。比较RNFLDi和RNFLBMO地形图的差异，并研究影响两种方法差异的因素。使用受试者操作特征曲线下面积（AUC）评估每种方法的青光眼诊断能力。
POAG患眼和健康眼的眼轴长度无差异。眼轴较长以及与倾斜视盘相关的外斜边界组织（BT）宽度较大是影响RNFLBMO和RNFLDi差异的两个主要因素（均P < 0.001）。与RNFLBMO相比，在有外斜BT的眼中，RNFLDi往往导致鼻侧RNFL更薄，而在没有外斜BT的眼中，RNFLBMO和RNFLDi相当。青光眼诊断能力总体相当，但在有较宽（>250μm）外斜BT的眼中，RNFLBMO优于RNFLDi（AUC分别为0.933和0.843，P = 0.027）。
以BMO为中心的新型视乳头周围RNFL扫描算法可能在倾斜视盘的眼中提供更可靠的RNFL轮廓，其青光眼诊断能力与传统算法基本相当。
