University Eye Clinic, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Policlinico San Matteo, Pavia, Italy.
IRCCS-Fondazione Bietti, Rome, Italy.
Invest Ophthalmol Vis Sci. 2018 Oct 1;59(12):4998-5010. doi: 10.1167/iovs.18-23813.
To compare the diagnostic capability of three-dimensional (3D) macular parameters against traditional two-dimensional (2D) retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography. To determine if manual correction and interpolation of B-scans improve the ability of 3D macular parameters to diagnose glaucoma.
A total of 101 open angle glaucoma patients (29 with early glaucoma) and 57 healthy subjects had peripapillary 2D RNFL thickness and 3D macular volume scans. Four parameters were calculated for six different-sized annuli: total macular thickness (M-thickness), total macular volume (M-volume), ganglion cell complex (GCC) thickness, and GCC volume of the innermost 3 macular layers (retinal nerve fiber layer + ganglion cell layer + inner plexiform layer). All macular parameters were calculated with and without correction and interpolation of frames with artifacts. The areas under the receiver operating characteristic curves (AUROC) were calculated for all the parameters.
The 3D macular parameter with the best diagnostic performance was GCC-volume-34, with an inner diameter of 3 mm and an outer of 4 mm. The AUROC for RNFL thickness and GCC-volume-34 were statistically similar for all regions (global: RNFL thickness 0.956, GCC-volume-34 0.939, P value = 0.3827), except for the temporal GCC-volume-34, which was significantly better than temporal RNFL thickness (P value = 0.0067). Correction of artifacts did not significantly change the AUROC of macular parameters (P values between 0.8452 and 1.0000).
The diagnostic performance of best macular parameters (GCC-volume-34 and GCC-thickness-34) were similar to or better than 2D RNFL thickness. Manual correction of artifacts with data interpolation is unnecessary in the clinical setting.
使用谱域光学相干断层扫描比较三维（3D）黄斑参数与传统二维（2D）视网膜神经纤维层（RNFL）厚度的诊断能力。确定手动校正和 B 扫描插值是否可以提高 3D 黄斑参数诊断青光眼的能力。
共纳入 101 例开角型青光眼患者（29 例为早期青光眼）和 57 例健康对照者，进行了视盘周围 2D RNFL 厚度和 3D 黄斑体积扫描。为 6 个不同大小的环计算了 4 个参数：总黄斑厚度（M 厚度）、总黄斑体积（M 体积）、节细胞复合体（GCC）厚度以及最内层 3 个黄斑层（视网膜神经纤维层+节细胞层+内丛状层）的 GCC 体积。所有黄斑参数均在存在和不存在帧伪影校正和插值的情况下进行计算。计算了所有参数的接收者操作特征曲线（AUROC）下面积。
最佳诊断性能的 3D 黄斑参数为 GCC-volume-34，内直径为 3mm，外直径为 4mm。对于所有区域（全局：RNFL 厚度 0.956，GCC-volume-34 0.939，P 值=0.3827），包括颞侧 GCC-volume-34，RNFL 厚度和 GCC-volume-34 的 AUROC 均无统计学差异，而颞侧 GCC-volume-34 的 AUROC 明显优于颞侧 RNFL 厚度（P 值=0.0067）。黄斑参数的 AUROC 未因校正伪影而显著改变（P 值介于 0.8452 至 1.0000 之间）。
最佳黄斑参数（GCC-volume-34 和 GCC-thickness-34）的诊断性能与 2D RNFL 厚度相似或优于后者。在临床环境中，手动校正伪影并进行数据插值是不必要的。
