Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
PLoS One. 2020 May 11;15(5):e0232700. doi: 10.1371/journal.pone.0232700. eCollection 2020.
To analyze the relationships between qualitative and quantitative parameters of spectral-domain optical coherence tomography (SD-OCT) and the central retinal sensitivity in patients with retinitis pigmentosa (RP).
Ninety-three eyes of 93 patients were finally enrolled, with a median age (quartile) of 58 (24.5) years. We assessed the patients using SD-OCT and the 10-2 program of a Humphry Field Analyzer (HFA). As a qualitative parameter, two graders independently classified the patients' SD-OCT images into five severity grades (grades 1-5) based on the severity of damage to the photoreceptor inner and outer segments (IS/OS) layer. As quantitative parameters, we measured the IS-ellipsoid zone (IS-EZ) width, IS/OS thickness, outer nuclear layer (ONL) thickness, central macular thickness (CMT, 1 and 3 mm) and macular cube (6 × 6 mm) volume and thickness. The central retinal sensitivity was defined by the best-corrected visual acuity (BCVA; logMAR), average sensitivities of the central 4 (foveal sensitivity [FS]) and 12 (macular sensitivity [MS]) points of the HFA 10-2 program and the mean deviation (MD) of the 10-2 program. Spearman's correlation was used to assess the association between both qualitative and quantitative parameters and variables of the central retinal sensitivity. In addition, we performed a multiple regression analysis using these parameters to identify the parameters most strongly influencing the central retinal sensitivity.
The IS/OS severity grade was significantly correlated with the BCVA (ρ = 0.741, P < 0.001), FS (ρ = -0.844, P < 0.001), MS (ρ = -0.820, P < 0.001) and MD (ρ = -0.681, P < 0.001) and showed stronger correlations to them than any other quantitative parameters including the IS-EZ width, IS/OS thickness, ONL thickness, CMTs and macular cube volume/thickness. Furthermore, a step-wise multiple regression analysis indicated that the IS/OS severity grade was more strongly associated with the BCVA (β = 0.659, P < 0.001), FS (β = -0.820, P < 0.001), MS (β = -0.820, P < 0.001) and MD (β = -0.674, P < 0.001) than any other quantitative parameters. The intraclass correlation coefficient between two graders indicated substantial correlation (κ = 0.70).
The qualitative grading of OCT based on the severity of the IS/OS layer was simple and strongly correlated with the central retinal sensitivity in patients with RP. It may be useful to assess the central visual function in patients with RP, although there is some variation in severity within the same severity grade.
分析光谱域光学相干断层扫描（SD-OCT）的定性和定量参数与色素性视网膜炎（RP）患者中心视网膜敏感度之间的关系。
最终纳入 93 例 93 只眼患者，中位年龄（四分位数）为 58（24.5）岁。我们使用 SD-OCT 和 Humphrey 视野分析仪（HFA）的 10-2 程序对患者进行评估。作为定性参数，两位分级员根据光感受器内节/外节（IS/OS）层损伤的严重程度，将患者的 SD-OCT 图像独立地分为 5 个严重程度等级（等级 1-5）。作为定量参数，我们测量了 IS-椭圆体带（IS-EZ）宽度、IS/OS 厚度、外核层（ONL）厚度、中央黄斑厚度（CMT，1 和 3mm）和黄斑立方（6×6mm）体积和厚度。中心视网膜敏感度由最佳矫正视力（BCVA；logMAR）、HFA 10-2 程序中央 4 个点（中心敏感度 [FS]）和 12 个点（黄斑敏感度 [MS]）的平均敏感度以及 10-2 程序的平均偏差（MD）定义。Spearman 相关用于评估定性和定量参数与中心视网膜敏感度变量之间的相关性。此外，我们使用这些参数进行多元回归分析，以确定对中心视网膜敏感度影响最大的参数。
IS/OS 严重程度分级与 BCVA（ρ=0.741，P<0.001）、FS（ρ=-0.844，P<0.001）、MS（ρ=-0.820，P<0.001）和 MD（ρ=-0.681，P<0.001）显著相关，与任何其他定量参数（包括 IS-EZ 宽度、IS/OS 厚度、ONL 厚度、CMT 和黄斑立方体积/厚度）相比，其相关性更强。此外，逐步多元回归分析表明，IS/OS 严重程度分级与 BCVA（β=0.659，P<0.001）、FS（β=-0.820，P<0.001）、MS（β=-0.820，P<0.001）和 MD（β=-0.674，P<0.001）的相关性均强于任何其他定量参数。两位分级员之间的组内相关系数表明存在高度相关性（κ=0.70）。
基于 IS/OS 层严重程度的 OCT 定性分级简单，与 RP 患者的中心视网膜敏感度密切相关。尽管在同一严重程度等级内存在一定的严重程度变化，但它可能有助于评估 RP 患者的中心视觉功能。
