Consultative-Diagnostic Department of Ophthalmology Center of the Federal Medical and Biological Agency of the Russian Federation, A.I. Burnazyan Federal Medical and Biophysical Center of FMBA, Ophthalmological Department of the Institute of Improvement of Professional Skill of FMBA, Moscow, Russian Federation.
Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russian Federation.
PLoS One. 2018 Aug 23;13(8):e0201599. doi: 10.1371/journal.pone.0201599. eCollection 2018.
To compare the diagnostic accuracy of structural parameters, vessel density (VD) measured by optical coherence tomography angiography (OCTA), and electrophysiological testing in diagnosis of primary open-angle glaucoma (POAG).
35 healthy participants and 90 POAG subjects underwent the measurement of whole image en face (wi) VD in the disc/peripapillary region and macula, the retinal nerve fiber layer (RNFL), and the average thickness of ganglion cell complex (GCC), pattern electroretinograms and pattern visual evoked potentials. The area under the receiver operating characteristic curve (AUC) was assessed for each parameter to differentiate early POAG from healthy eyes and between the POAG stages.
To distinguish early POAG from healthy eyes, the parameters with the highest AUC were detected: P50 amplitude of transient pattern electroretinogram, 1° (AUC 0.93, p = 0.002), P1 component of steady-state pattern electroretinogram (AUC 0.92, p = 0.003), P100 amplitude of pattern visual evoked potential, 1° (AUC 0.84, p = 0.013), wiVD macula superficial (AUC 0.80, p = 0.001), wiVD Disc (AUC 0.74, p = 0.016), GCC (AUC 0.74, p = 0.016) and to distinguish early POAG from the moderate to severe POAG: inferotemporal peripapillary VD (AUC 0.94, p < 0.0001) and focal loss volume of GCC (AUC 0.92, p < 0, 001).
Our results demonstrate the importance of measuring the microcirculation parameters in the macular area along with PERGs and PVEPs for the early detection of glaucoma. VD in the inferotemporal sector of the peripapillary retina and focal loss volume of the GCC are important for monitoring of the disease. The inclusion of OCTA, PERGs and PVEPs in glaucoma diagnostics may improve its early detection and monitoring.
比较结构参数、光学相干断层扫描血管造影（OCTA）测量的血管密度（VD）和电生理检查在原发性开角型青光眼（POAG）诊断中的诊断准确性。
35 名健康受试者和 90 名 POAG 患者接受了眼底/视盘区域和黄斑的全像面（wi）VD、视网膜神经纤维层（RNFL）和节细胞复合体（GCC）平均厚度、图形视网膜电图和图形视觉诱发电位的测量。评估每个参数的受试者工作特征曲线（ROC）下面积（AUC），以区分早期 POAG 与健康眼以及 POAG 各期之间的差异。
为了区分早期 POAG 与健康眼，检测到具有最高 AUC 的参数：瞬态图形视网膜电图 P50 振幅，1°（AUC 0.93，p=0.002），稳态图形视网膜电图 P1 成分（AUC 0.92，p=0.003），图形视觉诱发电位 P100 振幅，1°（AUC 0.84，p=0.013），黄斑浅层 wiVD（AUC 0.80，p=0.001），视盘 wiVD（AUC 0.74，p=0.016），GCC（AUC 0.74，p=0.016）；区分早期 POAG 与中重度 POAG：颞下视盘旁 VD（AUC 0.94，p<0.0001）和 GCC 局灶性容积损失（AUC 0.92，p<0.001）。
我们的结果表明，测量黄斑区微循环参数以及 PERGs 和 PVEPs 对青光眼的早期发现非常重要。视盘旁视网膜颞下区的 VD 和 GCC 的局灶性容积损失对于监测疾病非常重要。将 OCTA、PERGs 和 PVEPs 纳入青光眼诊断可能会提高其早期发现和监测能力。
