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超广角扫频源光学相干断层扫描在近视患者原发性开角型青光眼诊断中的准确性。

Diagnostic Accuracy of Wide-Field Map from Swept-Source Optical Coherence Tomography for Primary Open-Angle Glaucoma in Myopic Eyes.

机构信息

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea.

出版信息

Am J Ophthalmol. 2020 Oct;218:182-191. doi: 10.1016/j.ajo.2020.05.032. Epub 2020 Jun 20.

DOI:10.1016/j.ajo.2020.05.032
PMID:32574775
Abstract

PURPOSE

To compare the accuracy of glaucomatous defects and diagnostic power for primary open-angle glaucoma (POAG) between swept-source optical coherence tomography (SS-OCT) and spectral-domain OCT (SD-OCT) in myopic eyes.

DESIGN

Prospective, case-control study.

METHODS

A total of 150 myopic POAG eyes and 100 healthy myopic eyes underwent SD-OCT and SS-OCT in random order on the same day. The locations of glaucomatous defects on SD-OCT thickness and deviation maps and SS-OCT wide-field thickness (thickness surfaces) and SuperPixel maps were rated, and the maps' accuracies were compared. The area under receiver operating characteristic (AUROC) of the peripapillary retinal nerve fiber layer (RNFL) and the macular parameters (GCL++: equivalent to ganglion cell-inner plexiform layer [GCIPL] + RNFL; GCL+: equivalent to GCIPL) from each of the devices for myopic POAG were calculated and compared.

RESULTS

The wide-field RNFL thickness (thickness surface) map showed the best accuracy for glaucomatous defects in the inferotemporal (96.4%) and superotemporal (92.4%) regions. The RNFL/GCL++/GCL+ wide-field thickness (thickness surface) map showed better accuracy for glaucomatous defects in both the superotemporal and inferotemporal regions than with the SD-OCT thickness map (all P values <.05). The average GCL++ (87.6%) and GCL+ (87.5%) thicknesses showed significantly greater AUROC for myopic POAG than GCIPL thickness from SD-OCT (83.8%, all P values <.05).

CONCLUSIONS

In myopic eyes, the SS-OCT wide-field map exhibited better accuracy for glaucomatous defect and greater diagnostic power for POAG than SD-OCT outcomes. This result might have been due to SS-OCT's wider scan and measurement area.

摘要

目的

比较在近视眼中,扫频源光学相干断层扫描(SS-OCT)和谱域光学相干断层扫描(SD-OCT)在青光眼性缺陷和原发性开角型青光眼(POAG)诊断方面的准确性。

设计

前瞻性病例对照研究。

方法

150 只近视 POAG 眼和 100 只健康近视眼于同日分别随机接受 SD-OCT 和 SS-OCT 检查。对 SD-OCT 厚度和偏差图及 SS-OCT 宽视场厚度(厚度表面)和 SuperPixel 图上的青光眼性缺陷位置进行评分,并比较这些图谱的准确性。计算并比较来自每个设备的视盘周围视网膜神经纤维层(RNFL)和黄斑参数(GCL++:相当于神经节细胞内丛状层[GCIPL]+RNFL;GCL+:相当于 GCIPL)的受试者工作特征曲线(ROC)下面积(AUROC)。

结果

宽视场 RNFL 厚度(厚度表面)图在颞下(96.4%)和颞上(92.4%)区域的青光眼性缺陷中具有最佳准确性。RNFL/GCL++/GCL+宽视场厚度(厚度表面)图在颞上和颞下区域的青光眼性缺陷的准确性均优于 SD-OCT 厚度图(所有 P 值<.05)。平均 GCL++(87.6%)和 GCL+(87.5%)厚度对近视 POAG 的 AUROC 显著大于 SD-OCT 中 GCIPL 厚度(所有 P 值<.05)。

结论

在近视眼中,SS-OCT 宽视场图在青光眼性缺陷方面的准确性优于 SD-OCT 结果,对 POAG 的诊断能力也更强。这一结果可能是由于 SS-OCT 的扫描和测量区域更宽。

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