Shin Joong Won, Seong Mincheol, Lee Jung Wook, Hong Eun Hee, Uhm Ki Bang
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
J Ophthalmol. 2017;2017:8365090. doi: 10.1155/2017/8365090. Epub 2017 Jan 10.
. To evaluate the diagnostic ability of the retinal nerve fiber layer (RNFL) deviation map for glaucoma with localized or diffuse RNFL defects. . Eyes of 139 glaucoma patients and 165 healthy subjects were enrolled. All participants were imaged with Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA). A RNFL defect was defined as at least 10 contiguous red (<1% level) superpixels in RNFL deviation map. The area, location, and angular width of RNFL defects were automatically measured. We compared sensitivities, specificities, and area under the receiver operating characteristic curves (AUCs) of RNFL deviation map and circumpapillary RNFL thickness for localized and diffuse RNFL defects. Subgroup analysis was performed according to the severity of glaucoma. . For localized defects, the area of RNFL defects (AUC, 0.991; sensitivity, 97%; specificity, 90%) in deviation map showed a higher diagnostic performance ( = 0.002) than the best circumpapillary RNFL parameter (inferior RNFL thickness; AUC, 0.914; sensitivity, 79%; specificity, 92%). For diffuse defects, there was no significant difference between the RNFL deviation map and circumpapillary RNFL parameters. In mild glaucoma with localized defect, RNFL deviation map showed a better diagnostic performance than circumpapillary RNFL measurement. . RNFL deviation map is a useful tool for evaluating glaucoma regardless of localized or diffuse defect type and has advantages over circumpapillary RNFL measurement for detecting localized RNFL defects.
评估视网膜神经纤维层（RNFL）偏差图对伴有局限性或弥漫性RNFL缺损的青光眼的诊断能力。纳入139例青光眼患者和165例健康受试者的眼睛。所有参与者均使用Cirrus HD-OCT（美国加利福尼亚州都柏林市卡尔蔡司医疗技术公司）进行成像。RNFL缺损定义为RNFL偏差图中至少10个连续的红色（<1%水平）超像素。自动测量RNFL缺损的面积、位置和角宽度。我们比较了RNFL偏差图和视盘周围RNFL厚度对局限性和弥漫性RNFL缺损的敏感性、特异性和受试者操作特征曲线下面积（AUC）。根据青光眼的严重程度进行亚组分析。对于局限性缺损，偏差图中RNFL缺损的面积（AUC，0.991；敏感性，97%；特异性，90%）显示出比最佳视盘周围RNFL参数（下方RNFL厚度；AUC，0.914；敏感性，79%；特异性，92%）更高的诊断性能（P = 0.002）。对于弥漫性缺损，RNFL偏差图和视盘周围RNFL参数之间无显著差异。在伴有局限性缺损的轻度青光眼中，RNFL偏差图显示出比视盘周围RNFL测量更好的诊断性能。RNFL偏差图是评估青光眼的有用工具，无论缺损类型是局限性还是弥漫性，并且在检测局限性RNFL缺损方面比视盘周围RNFL测量具有优势。
