Kim Hae Jin, Lee Sang-Yoon, Park Ki Ho, Kim Dong Myung, Jeoung Jin Wook
Department of Ophthalmology Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea.
Invest Ophthalmol Vis Sci. 2016 Sep 1;57(11):4799-4805. doi: 10.1167/iovs.16-19214.
To evaluate the diagnostic ability of layer-by-layer segmented macular ganglion cell complex (GCC) using spectral-domain optical coherence tomography (OCT) for detection of glaucoma and to analyze the topographic patterns of the segmented thicknesses in open-angle glaucoma.
Seventy-seven open-angle glaucoma patients and 59 healthy subjects were enrolled in this cross-sectional study. Spectral-domain OCT with automated segmentation was used to measure the separate thicknesses of macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL). We compared the specific diagnostic abilities of the GCC (RNFL+GCL+IPL), ganglion cell-inner plexiform layer (GCIPL: GCL+IPL), and circumpapillary RNFL (cpRNFL) to discriminate between normal eyes and glaucoma.
The mRNFL, GCL, IPL, and cpRNFL thicknesses in glaucoma patients were all significantly thinner compared with healthy subjects and showed different topographic patterns. The GCC, mRNFL, and GCL thicknesses were best able to discriminate between the glaucoma and normal groups. The areas under the curve of receiver operating characteristics (AUROCs) of the mRNFL and GCL did not show significant difference from that of the cpRNFL. The AUROC of the GCL did not show significant difference from that of GCIPL after Bonferroni correction. The global IPL thickness had the smallest AUROC and showed lower diagnostic performance than the GCL, GCIPL, and GCC.
The diagnostic ability of segmented mRNFL and GCL to discriminate between normal and glaucoma eyes is high and comparable to that of cpRNFL thickness. The measurement and monitoring of GCL could be a practical and effective approach to glaucoma diagnostics.
利用光谱域光学相干断层扫描（OCT）评估逐层分割的黄斑神经节细胞复合体（GCC）检测青光眼的诊断能力，并分析开角型青光眼分割厚度的地形图模式。
本横断面研究纳入了77例开角型青光眼患者和59例健康受试者。使用具有自动分割功能的光谱域OCT测量黄斑视网膜神经纤维层（mRNFL）、神经节细胞层（GCL）和内网状层（IPL）的单独厚度。我们比较了GCC（RNFL+GCL+IPL）、神经节细胞-内网状层（GCIPL：GCL+IPL）和视乳头周围RNFL（cpRNFL）区分正常眼和青光眼的特定诊断能力。
与健康受试者相比，青光眼患者的mRNFL、GCL、IPL和cpRNFL厚度均显著变薄，且呈现不同的地形图模式。GCC、mRNFL和GCL厚度最能区分青光眼组和正常组。mRNFL和GCL的受试者操作特征曲线下面积（AUROC）与cpRNFL的相比无显著差异。经Bonferroni校正后，GCL的AUROC与GCIPL的相比无显著差异。整体IPL厚度的AUROC最小，其诊断性能低于GCL、GCIPL和GCC。
分割后的mRNFL和GCL区分正常眼和青光眼的诊断能力较高，与cpRNFL厚度相当。测量和监测GCL可能是一种实用且有效的青光眼诊断方法。
