Vidas Sania, Popović-Suić Smiljka, Novak Lauš Katia, Jandroković Sonja, Tomić Martina, Jukić Tomislav, Kalauz Miro
Clinical Department of Ophthalmology, Zagreb University Hospital Center, Zagreb, Croatia.
University of Zagreb, School of Medicine, Zagreb, Croatia.
Acta Clin Croat. 2017 Sep;56(3):382-390. doi: 10.20471/acc.2017.56.03.04.
The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL.
目的是比较原发性开角型青光眼(POAG)、高眼压症(OH)患者及健康受试者的视网膜神经纤维层(RNFL)和神经节细胞复合体(GCC)厚度,并研究GCC参数在青光眼诊断中的作用。81例患者根据霍达普-帕里什-安德森分类法分为四组:26例高眼压症患者、22例早期POAG患者、10例中度至重度POAG患者和23例健康受试者。所有患者均使用SOCT Copernicus HR测量RNFL和GCC厚度。POAG患者的所有RNFL和GCC参数均显著低于高眼压症患者和健康受试者,尤其是平均RNFL、RNFL上象限和下象限、GCC平均值以及GCC下象限。在所有RNFL参数中,平均RNFL的受试者工作特征曲线(AUC)下面积最高,为0.906。GCC平均值以及GCC上象限和下象限的总体AUC最高(分别为0.957、0.955和0.946),特异性为100%。RNFL平均值和下象限以及GCC平均值、上象限和下象限被确定为青光眼发生的主要预测指标(分别与p=0.002、p=0.002和p=0.003相比,p=0.015和p=0.014)。总之,与RNFL相比,GCC参数显示出稍好的青光眼鉴别能力,并且被发现是青光眼发生的更好预测指标。