Yapp Michael, Rennie George, Hennessy Michael P, Kalloniatis Michael, Zangerl Barbara
Centre for Eye Health, UNSW Australia, Sydney, New South Wales, Australia.
School of Optometry and Vision Science, UNSW Australia, Sydney, New South Wales, Australia.
PLoS One. 2018 Jan 17;13(1):e0190273. doi: 10.1371/journal.pone.0190273. eCollection 2018.
Optic nerve head (ONH) assessment and its interpretation in healthy patients and those with glaucoma remains a pivotal topic specifically considering rapid advancements in imaging technologies. We undertook a large-scale, mixed cohort, comparative study to assess the correlation of optic disc measurements between different imaging modalities and investigated the impact of patient and disc associated parameters.
ONH sizes were obtained from one randomly selected eye of each of 209 patients using stereophotography, confocal scanning laser ophthalmoscopy and two different optical coherence tomographers (OCT). Patient related data, glaucoma status and optic disc variables, specifically oblique insertion, torsion, presence of beta PPA and spherical equivalent were recorded. Measurements between imaging modalities were analysed using Pearson correlation, linear regression analysis and Blend-Altman plots. Individual variables were compared applying multivariate regression analysis, ANOVA and chi square statistics was used to determine correlations between patient and clinical characteristics.
Absolute measurements significantly differed between imaging modalities generally producing smaller measurements for OCT derived measurements of Bruch's membrane opening (BMO). Pairwise correlations between imaging modalities were between 0.83 and 0.93 for discs without myopia, oblique insertion, or beta PPA. These features impacted on measurements for individual modalities and consequently contributed to inconsistencies and variability.
In comparison to planimetry, OCT derived BMO measurements are more variable in the presence of oblique insertion, beta PPA or magnification errors due to myopia. Impact of these factors, however, differs between instruments and needs to be considered to accurately interpret optic disc features in particular within the context of glaucoma diagnosis.
鉴于成像技术的快速发展，视神经乳头（ONH）评估及其在健康患者和青光眼患者中的解读仍然是一个关键话题。我们开展了一项大规模、混合队列、对比研究，以评估不同成像方式之间视盘测量值的相关性，并研究患者和视盘相关参数的影响。
使用立体摄影、共焦扫描激光眼底镜检查和两种不同的光学相干断层扫描仪（OCT），从209例患者中随机选取一只眼睛获取ONH大小。记录患者相关数据、青光眼状态和视盘变量，特别是倾斜插入、扭转、β旁中心凹周区（beta PPA）的存在情况和等效球镜度。使用Pearson相关性分析、线性回归分析和Bland-Altman图分析成像方式之间的测量值。应用多变量回归分析比较个体变量，使用方差分析和卡方统计来确定患者与临床特征之间的相关性。
成像方式之间的绝对测量值存在显著差异，通常OCT得出的布鲁赫膜开口（BMO）测量值较小。对于没有近视、倾斜插入或beta PPA的视盘，成像方式之间的成对相关性在0.83至0.93之间。这些特征影响了个体成像方式的测量值，因此导致了不一致性和变异性。
与平面测量法相比，在存在倾斜插入、beta PPA或近视引起的放大误差时，OCT得出的BMO测量值变异性更大。然而，这些因素的影响在不同仪器之间存在差异，在青光眼诊断的背景下，尤其需要考虑这些因素以准确解读视盘特征。
