Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
Acta Ophthalmol. 2019 Feb;97(1):60-67. doi: 10.1111/aos.13698. Epub 2018 Mar 24.
To characterize the two-dimensional parameter Bruch's membrane opening minimum rim area (BMO-MRA) in spectral domain optical coherence tomography (SD-OCT) of the optic nerve head (ONH) compared to minimum rim width (BMO-MRW) and retinal nerve fibre layer (RNFL) thickness in a large patient cohort.
Case-control, cross-sectional study of 705 eyes of 445 participants. A total of 449 eyes with glaucoma, 67 eyes with ocular hypertension and 189 healthy controls, underwent SD-OCT and confocal laser scanning tomography (CSLT), visual field testing and clinical examination. Morphometric ONH parameters, visual field function and diagnostic power were compared. Main outcome measures were SD-OCT-derived BMO-MRA, BMO-MRW, RNFL thickness and CSLT-derived rim area (DM-RA).
Mean ONH area was 2.11 ± 0.57 mm ; mean BMO area was 1.89 ± 0.45 mm . Correlation of mean deviation in visual field to morphometric parameters was ρ = 0.70, (p < 0.001) for RNFL thickness, ρ = 0.68 (p < 0.001) for BMO-MRA, ρ = 0.66 (p < 0.001) for BMO-MRW. These correlations were not significantly different (p > 0.05), while DM-RA correlated significantly worse (ρ = 0.55; p < 0.001). In receiver operating characteristics, the calculated area under the curve (AUC) and sensitivity at 90% specificity to differentiate glaucoma were 0.87% and 70.1% for BMO-MRA, 0.86% and 68.1% for RNFL thickness, 0.84% and 66.0% for BMO-MRW, 0.82% and 51.3% for DM-RA.
In a heterogenous clinical cohort of glaucoma patients, all analysed SD-OCT parameters excel DM-RA of CSLT. The two-dimensional parameter BMO-MRA shows comparable levels of diagnostic power to detect glaucoma compared to established parameters BMO-MRW and RNFL thickness. Given higher comparability between ONH sizes, BMO-MRA might become an additional standard tool in SD-OCT imaging for glaucoma.
在视神经头（ONH）的光谱域光学相干断层扫描（SD-OCT）中，与最小边缘宽度（BMO-MRW）和视网膜神经纤维层（RNFL）厚度相比，对二维参数Bruch 膜开口最小边缘区域（BMO-MRA）进行特征描述，该研究纳入了大量患者。
这是一项包含 445 名参与者的 705 只眼的病例对照、横断面研究。总共纳入 449 只青光眼眼、67 只高眼压眼和 189 只健康对照眼，对其进行 SD-OCT 和共焦激光扫描断层扫描（CSLT）、视野检查和临床检查。比较了视神经头形态参数、视野功能和诊断能力。主要观察指标为 SD-OCT 衍生的 BMO-MRA、BMO-MRW、RNFL 厚度和 CSLT 衍生的边缘区域（DM-RA）。
平均 ONH 面积为 2.11±0.57mm；平均 BMO 面积为 1.89±0.45mm。视野中平均偏差与形态学参数的相关性为 ρ=0.70（p<0.001），与 RNFL 厚度相关，ρ=0.68（p<0.001），与 BMO-MRA 相关，ρ=0.66（p<0.001），与 BMO-MRW 相关。这些相关性没有显著差异（p>0.05），而 DM-RA 的相关性明显较差（ρ=0.55；p<0.001）。在受试者工作特征曲线中，计算出的曲线下面积（AUC）和 90%特异性区分青光眼的敏感性分别为 BMO-MRA 为 0.87%和 70.1%，RNFL 厚度为 0.86%和 68.1%，BMO-MRW 为 0.84%和 66.0%，DM-RA 为 0.82%和 51.3%。
在青光眼患者的异质临床队列中，所有分析的 SD-OCT 参数均优于 CSLT 的 DM-RA。二维参数 BMO-MRA 与已建立的 BMO-MRW 和 RNFL 厚度参数相比，具有相当的诊断能力，可以检测青光眼。鉴于 ONH 大小之间的可比性更高，BMO-MRA 可能成为 SD-OCT 成像中青光眼的另一个标准工具。
