Zivkovic Maja, Dayanir Volkan, Zlatanovic Marko, Zlatanovic Gordana, Jaksic Vesna, Jovanovic Predrag, Radenkovic Marija, Djordjevic-Jocic Jasmina, Stankovic-Babic Gordana, Jovanovic Svetlana
Ophthalmology Clinic, Clinical Center Niš, University of Niš, Niš, Serbia.
Ophthalmic Res. 2018;59(3):148-154. doi: 10.1159/000478052. Epub 2017 Sep 7.
To compare ganglion cell (GCL) and inner plexiform layer (IPL) thickness in patients at different stages of primary open-angle glaucoma (POAG), determine their sensitivity and specificity values, and correlate thickness values with mean deviations (MD).
This prospective, cross- sectional study was conducted in a group of patients with confirmed POAG who were compared to an age- and gender-matched control group. Glaucomatous damage was classified according to the Hodapp-Parrish-Anderson scale: glaucoma stage 1 (early), glaucoma stage 2 (moderate), and glaucoma stage 3 (severe). The average, minimum, and all 6 sectoral (superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal) GCL + IPL thicknesses were measured and compared between groups.
The average GCL + IPL thickness of 154 eyes of 93 patients in glaucoma stages 1, 2, 3, and 94 eyes of 47 persons in the control group were 76.79 ± 8.05, 65.90 ± 7.92, 57.38 ± 10.00, and 86.01 ± 3.68 μm, respectively. There were statistically significant differences in the average, minimum, and all 6 sectoral GCL + IPL values among the groups. The areas under the receiver operating characteristic curve for average and minimum GCL + IPL thickness values were 0.93 and 0.94, respectively, sensitivity 91.5 and 88.3%, and specificity 98.9 and 100%, respectively. Both thickness values showed significant correlations with MD. Each micrometer decrease in the average GCL + IPL thickness was associated with a 0.54-dB loss in MD.
GCL + IPL layer thickness is a highly specific and sensitive parameter in differentiating glaucomatous from healthy eyes showing progressive damage as glaucoma worsens. Loss of this layer is highly correlated with overall loss of visual field sensitivity.
比较原发性开角型青光眼（POAG）不同阶段患者的神经节细胞层（GCL）和内网状层（IPL）厚度，确定其敏感性和特异性值，并将厚度值与平均偏差（MD）进行关联。
本前瞻性横断面研究纳入一组确诊为POAG的患者，并与年龄和性别匹配的对照组进行比较。根据Hodapp-Parrish-Anderson量表对青光眼损害进行分类：青光眼1期（早期）、青光眼2期（中度）和青光眼3期（重度）。测量并比较两组的平均、最小以及所有6个扇形区域（颞上、上方、鼻上、鼻下、下方和颞下）的GCL + IPL厚度。
青光眼1期、2期、3期的93例患者的154只眼以及对照组47例患者的94只眼的平均GCL + IPL厚度分别为76.79±8.05、65.90±7.92、57.38±10.00和86.01±3.68μm。各组之间的平均、最小以及所有6个扇形区域的GCL + IPL值存在统计学显著差异。平均和最小GCL + IPL厚度值的受试者操作特征曲线下面积分别为0.93和0.94，敏感性分别为91.5%和88.3%，特异性分别为98.9%和100%。两个厚度值均与MD显示出显著相关性。平均GCL + IPL厚度每减少1μm，MD损失0.54dB。
GCL + IPL层厚度是区分青光眼性眼与健康眼的高度特异性和敏感性参数，随着青光眼病情恶化，该层会逐渐受损。该层的缺失与视野敏感性的整体丧失高度相关。
