Ghassibi Mark P, Chien Jason L, Patthanathamrongkasem Thipnapa, Abumasmah Ramiz K, Rosman Michael S, Skaat Alon, Tello Celso, Liebmann Jeffrey M, Ritch Robert, Park Sung Chul
*Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai§Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital¶Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Medical Center, Harkness Eye Institute, New York∥Department of Ophthalmology, Hofstra Northwell School of Medicine, Hempstead, NY†George Washington University School of Medicine and Health Sciences, Washington, DC‡Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Glaucoma. 2017 Apr;26(4):335-342. doi: 10.1097/IJG.0000000000000610.
To compare varying circumpapillary optical coherence tomographic (OCT) scan diameters for glaucoma diagnosis.
Prospective, cross-sectional, observational study. Circumpapillary retinal nerve fiber layer thickness (RNFLT) was measured using spectral-domain OCT in 1 randomly selected eye. Scans with diameters of 3.5, 4.1, and 4.7 mm were obtained, each with 7 parameters: mean global (G) RNFLT and mean RNFLT for the temporal-inferior (TI), nasal-inferior (NI), temporal-superior (TS), nasal-superior (NS), nasal (N), and temporal (T) sectors. Areas under the receiver operating characteristic curve (AUCs) were calculated.
Mean age was 55±18 years in 68 healthy eyes and 59±15 years in 95 glaucomatous eyes (P=0.12). Visual field mean deviation was -7.55±6.61 dB in glaucomatous eyes. In all 3 circle scans, mean TI RNFLT had the greatest AUC (0.974 to 0.983), followed by mean G RNFLT (0.949 to 0.956). The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean TI RNFLTs in the 4.7- (0.978; P=0.128) and 3.5-mm (0.974; P=0.049) scans. The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean G RNFLTs in the 3.5- (0.954; P=0.011), 4.1- (0.956; P=0.016), and 4.7-mm (0.949; P=0.011) scans. In 2 eyes with large parapapillary atrophy, RNFL segmentation error was noted only in the 3.5-mm scan in the area of parapapillary atrophy.
Further investigations to find the spectral-domain OCT circle scan diameter with the best diagnostic capability and the least artifacts are warranted, especially focusing on larger-than-conventional circle scans.
比较不同圆周视乳头光学相干断层扫描（OCT）扫描直径用于青光眼诊断的情况。
前瞻性、横断面、观察性研究。使用光谱域OCT在1只随机选择的眼中测量视乳头周围视网膜神经纤维层厚度（RNFLT）。获得直径为3.5、4.1和4.7mm的扫描图像，每张图像有7个参数：平均整体（G）RNFLT以及颞下（TI）、鼻下（NI）、颞上（TS）、鼻上（NS）、鼻侧（N）和颞侧（T）扇形区的平均RNFLT。计算受试者工作特征曲线下面积（AUC）。
68只健康眼的平均年龄为55±18岁，95只青光眼眼的平均年龄为59±15岁（P = 0.12）。青光眼眼的视野平均偏差为-7.55±6.61dB。在所有3种圆周扫描中，平均TI RNFLT的AUC最大（0.974至0.983），其次是平均G RNFLT（0.949至0.956）。4.1mm扫描中平均TI RNFLT的AUC（0.983）大于4.7mm（0.978；P = 0.128）和3.5mm（0.974；P = 0.049）扫描中平均TI RNFLT的AUC。4.1mm扫描中平均TI RNFLT的AUC（0.983）大于3.5mm（0.954；P = 0.011）、4.1mm（0.956；P = 0.016）和4.7mm（0.949；P = 0.011）扫描中平均G RNFLT的AUC。在2只伴有大的视乳头旁萎缩的眼中，仅在3.5mm扫描的视乳头旁萎缩区域发现RNFL分割错误。
有必要进一步研究以找到具有最佳诊断能力且伪像最少的光谱域OCT圆周扫描直径，尤其应关注大于传统的圆周扫描。
