Hwang Young Hoon, Kim Min Kyung, Wi Jae Min, Chung Jae Keun, Lee Kwan Bok
Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea.
Clin Exp Optom. 2018 Jan;101(1):100-108. doi: 10.1111/cxo.12556. Epub 2017 May 24.
The aim was to investigate the agreement for detection of progression of glaucomatous retinal nerve fibre layer defects (RNFLD) between optical coherence tomography-guided progression analysis (OCT GPA) and conventional red-free fundus photography.
Four hundred and fifteen glaucomatous eyes that underwent at least four serial red-free photographic and OCT examinations were included in the study. Based on the inspection of the red-free fundus photographs and GPA maps, RNFLD progression was defined as the development of a new defect, widening or deepening of a pre-existing RNFLD in red-free fundus photography (photographic progression) or 'Likely Loss' on a GPA map (GPA progression). The agreement of photographic and OCT GPA progression and the factors influencing it, including refractive error, severity of glaucoma (mean deviation of the visual field), type of RNFLD (localised versus diffuse), width of the baseline RNFLD, type of RNFLD progression (new defect, widening, deepening) and location of RNFLD progression (clock-hour sector) were assessed.
Among the 415 eyes, 82 (19.8 per cent) showed photographic or GPA progression. Among the 82 eyes with progression, progression was detected only in red-free fundus photography in nine (11.0 per cent) eyes and only in GPA in 32 (39.0 per cent) eyes. In 41 eyes (50.0 per cent), progression was detected with both methods. Detection of RNFLD progression only in GPA was associated with a higher myopia, diffuse RNFLD, deepening of the RNFLD and RNFLD progression at the 6, 9 and 12 o'clock positions (p < 0.05).
OCT GPA may be a useful supplement to conventional red-free fundus photography for detecting RNFLD progression.
本研究旨在探讨光学相干断层扫描引导下的进展分析（OCT GPA）与传统无赤光眼底照相术在检测青光眼性视网膜神经纤维层缺损（RNFLD）进展方面的一致性。
本研究纳入了415只青光眼患眼，这些患眼至少接受了四次连续的无赤光眼底照相和OCT检查。基于对无赤光眼底照片和GPA图的检查，RNFLD进展被定义为在无赤光眼底照相中出现新的缺损、已存在的RNFLD增宽或加深（照相进展），或在GPA图上出现“可能丢失”（GPA进展）。评估了照相和OCT GPA进展的一致性及其影响因素，包括屈光不正、青光眼严重程度（视野平均偏差）、RNFLD类型（局限性与弥漫性）、基线RNFLD宽度、RNFLD进展类型（新缺损、增宽、加深）以及RNFLD进展部位（钟点方位）。
在415只眼中，82只（19.8%）出现了照相或GPA进展。在这82只出现进展的眼中，仅在无赤光眼底照相中检测到进展的有9只（11.0%），仅在GPA中检测到进展的有32只（39.0%）。41只眼（50.0%）通过两种方法均检测到进展。仅在GPA中检测到RNFLD进展与更高的近视度数、弥漫性RNFLD、RNFLD加深以及RNFLD在6点、9点和12点方位的进展相关（p<0.05）。
OCT GPA对于检测RNFLD进展可能是传统无赤光眼底照相术的有用补充。
