Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
CeMSIIS, Institute for Medical Statistics, Medical University of Vienna, Vienna, Austria.
Retina. 2018 Apr;38(4):820-827. doi: 10.1097/IAE.0000000000001631.
Reduced thickness of the ganglion cell inner plexiform layer indicates diabetic neurodegeneration and can be assessed by spectral domain optical coherence tomography. The authors investigated the comparability of ganglion cell inner plexiform layer measurements from two spectral domain optical coherence tomography devices in patients with diabetic macular edema (DME).
Analysis of optical coherence tomography data sets of eyes with and fellow eyes without DME. Macular cube scans of sufficient signal strength on Cirrus (Carl Zeiss Meditec) were compared with correlating scans on Spectralis (Heidelberg Engineering, Germany) being acquired within 1 hour.
Eighty-one equivalent data sets for 20 eyes with DME (20 patients; 6 female) and 33 for 9 fellow eyes without DME (9 patients; 2 female) were included from each device. In DME eyes, mean ganglion cell inner plexiform layer thicknesses were 62.5 ± 20.4 μm on Cirrus and 91.2 ± 9.3 μm on Spectralis. Ganglion cell inner plexiform layer was significantly thicker on Spectralis analyzing eyes with and without signs of DME (P < 0.001). The ganglion cell inner plexiform layer variance (54.2%) related to device differences decreased to 34.8% in eyes without DME.
Ganglion cell inner plexiform layer data from different devices vary considerably and cannot be used interchangeably. As spectral domain optical coherence tomography is indispensable for identifying ganglion cell loss associated with diabetic neurodegeneration, clinicians should be aware of the difference when monitoring patients.
神经节细胞内丛状层厚度变薄提示糖尿病性神经退行性变，可通过频域光相干断层扫描进行评估。作者研究了两种频域光相干断层扫描设备在糖尿病性黄斑水肿（DME）患者的神经节细胞内丛状层测量中的可比性。
对有和无 DME 的眼的光相干断层扫描数据集进行分析。Cirrus（卡尔蔡司医学技术公司）上具有足够信号强度的黄斑立方体扫描与在 1 小时内获得的 Spectralis（德国海德堡工程公司）上的相关扫描进行比较。
纳入了来自每个设备的 20 只 DME 眼（20 例；6 名女性）和 33 只无 DME 的对侧眼（9 例；2 名女性）的 81 对等效数据集。在 DME 眼中，Cirrus 上的平均神经节细胞内丛状层厚度为 62.5 ± 20.4μm，Spectralis 上为 91.2 ± 9.3μm。Spectralis 分析有和无 DME 迹象的眼的神经节细胞内丛状层明显更厚（P < 0.001）。在无 DME 的眼中，与设备差异相关的神经节细胞内丛状层方差（54.2%）降至 34.8%。
不同设备的神经节细胞内丛状层数据差异很大，不能互换使用。由于频域光相干断层扫描对于识别与糖尿病性神经退行性变相关的神经节细胞丢失是不可或缺的，因此在监测患者时，临床医生应该意识到这一差异。
