Thenappan Abinaya, De Moraes Carlos Gustavo, Wang Diane L, Xin Daiyan, Jarukasetphon Ravivarn, Ritch Robert, Hood Donald C
*Department of Psychology, Columbia University †Department of Ophthalmology, Columbia University ‡Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY.
J Glaucoma. 2017 May;26(5):473-477. doi: 10.1097/IJG.0000000000000654.
To determine whether the change in the retinal nerve fiber layer (RNFL) thickness in a region of interest (ROI) is a better measure of glaucoma progression than the change in average circumpapillary (cp) RNFL thickness.
Disc cube scans were obtained with frequency domain optical coherence tomography from 60 eyes of 60 patients (age, 61.7±12.7 y) with early or suspected glaucoma and controlled intraocular pressure. The average time between 2 test dates was 3.2±1.8 years. En-face images of the scans from the 2 tests were aligned based on the blood vessels, and cp images were derived for an annulus 100 μm wide and 3.4 mm in diameter, centered on the disc. An ROI was defined as the portion of the circumpapillary retinal nerve fiber layer (cpRNFL) plot within the temporal disc that extended below the 1% confidence interval for ≥5 degrees. Trend analysis using multilevel mixed-effects models was used to compare the rates of change between ROI width and average cpRNFL thickness.
In total, 26 of the 60 eyes had a total of 33 ROIs. The ROI width significantly increased between the 2 test dates (median, 4.9 degrees; Q1=1.03 degrees, Q3=10.5 degrees). In comparison, the average cpRNFL thickness did not decrease significantly over the same period (median, -0.7 μm; Q1=-2.7 μm, Q3=2.7 μm). Mixed-effects linear models confirmed significant ROI progression (P=0.015), but not average cpRNFL (P=0.878).
In this population, RNFL thinning in a ROI is a better measure of progression than is average cpRNFL thickness change.
确定与平均视盘周围视网膜神经纤维层（cpRNFL）厚度变化相比，感兴趣区域（ROI）内视网膜神经纤维层（RNFL）厚度变化是否能更好地衡量青光眼进展。
对60例（年龄61.7±12.7岁）早期或疑似青光眼且眼压控制良好的患者的60只眼进行频域光学相干断层扫描获取视盘立方体扫描图像。两次检查日期之间的平均时间为3.2±1.8年。基于血管对两次检查的扫描正面图像进行对齐，并获取以视盘为中心、宽度100μm、直径3.4mm的环的cp图像。ROI定义为颞侧视盘内视盘周围视网膜神经纤维层（cpRNFL）图中延伸至低于1%置信区间≥5度的部分。使用多级混合效应模型进行趋势分析，以比较ROI宽度和平均cpRNFL厚度的变化率。
60只眼中共有26只眼出现总共33个ROI。两次检查日期之间ROI宽度显著增加（中位数为4.9度；第一四分位数Q1 = 1.03度，第三四分位数Q3 = 10.5度）。相比之下，同期平均cpRNFL厚度没有显著降低（中位数为 -0.7μm；第一四分位数Q1 = -2.7μm，第三四分位数Q3 = 2.7μm）。混合效应线性模型证实ROI有显著进展（P = 0.015），但平均cpRNFL无显著进展（P = 0.878）。
在该人群中，ROI内RNFL变薄比平均cpRNFL厚度变化能更好地衡量青光眼进展。
