使用高清光学相干断层扫描技术测量开角型青光眼的三维神经视网膜边缘厚度和视网膜神经纤维层厚度
Three dimensional neuro-retinal rim thickness and retinal nerve fiber layer thickness using high-definition optical coherence tomography for open-angle glaucoma.
作者信息
Subramaniam Suresh, Jeoung Jin Wook, Lee Won June, Kim Young Kook, Park Ki Ho
机构信息
Department of Ophthalmology, Seoul National University Hospital, 101, Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea.
Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Star, Kedah, Malaysia.
出版信息
Jpn J Ophthalmol. 2018 Nov;62(6):634-642. doi: 10.1007/s10384-018-0620-7. Epub 2018 Sep 18.
PURPOSE
To compare the diagnostic capability of three-dimensional (3D) neuro-retinal rim thickness (NRR) with existing optic nerve head and retinal nerve fiber layer (RNFL) scan parameters using high-definition optical coherence tomography (HD-OCT).
DESIGN
Retrospective study.
METHODS
Based on the mean deviation (MD) of the Humphrey Field Analyzer (HFA), the 152 subjects were categorized into mild (MD > - 6 dB, 100), moderate (MD - 6 to - 12 dB, 26), and severe (MD < - 12 dB, 26) glaucoma. The HD-OCT values of NRR, RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses, along with those of other parameters (rim area, disc area) were obtained, and the average NRR thickness was calculated.
RESULTS
For all of the HD-OCT parameters, RNFL thickness showed a higher area under the ROC (AUROC) curve (range: 0.937-1.000) than did NRR thickness (range: 0.827-1.000). There were significant RNFL, NRR, and GCIPL AUROC curve differences among the mild, moderate and severe glaucoma groups. RNFL thickness for mild glaucoma showed a significantly larger area than did NRR thickness [area difference: 0.110 (± 0.025); p value < 0.0001). Furthermore, RNFL relative to NRR thickness yielded higher sensitivity (85-100% vs. 72-100%) and specificity (89-100% vs. 84-100%) for diagnosis of glaucoma.
CONCLUSION
RNFL thickness remains significantly better than 3D NRR thickness in terms of glaucoma-diagnostic capability in HD-OCT.
目的
使用高清光学相干断层扫描（HD - OCT）比较三维（3D）神经视网膜边缘厚度（NRR）与现有的视神经乳头和视网膜神经纤维层（RNFL）扫描参数的诊断能力。
设计
回顾性研究。
方法
根据 Humphrey 视野分析仪（HFA）的平均偏差（MD），将 152 名受试者分为轻度（MD > - 6 dB，100 例）、中度（MD - 6 至 - 12 dB，26 例）和重度（MD < - 12 dB，26 例）青光眼。获取 NRR、RNFL 和神经节细胞内丛状层（GCIPL）厚度的 HD - OCT 值，以及其他参数（边缘面积、视盘面积）的值，并计算平均 NRR 厚度。
结果
对于所有 HD - OCT 参数，RNFL 厚度在 ROC（AUROC）曲线下的面积（范围：0.937 - 1.000）高于 NRR 厚度（范围：0.827 - 1.000）。轻度、中度和重度青光眼组之间的 RNFL、NRR 和 GCIPL 的 AUROC 曲线存在显著差异。轻度青光眼的 RNFL 厚度显示的面积明显大于 NRR 厚度[面积差异：0.110（±0.025）；p 值 < 0.0001]。此外，相对于 NRR 厚度，RNFL 厚度在青光眼诊断中具有更高的敏感性（85 - 100% 对 72 - 100%）和特异性（89 - 100% 对 84 - 100%）。
结论
就 HD - OCT 中的青光眼诊断能力而言，RNFL 厚度仍显著优于 3D NRR 厚度。
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