Kang Dong Hyun, Hwang Young Hoon
Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea (the Republic of).
Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea (the Republic of)
Br J Ophthalmol. 2021 Jun;105(6):783-788. doi: 10.1136/bjophthalmol-2019-315715. Epub 2020 Jun 25.
To evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA).
A total of 53 eyes with either RNFL or GCIPL progression determined using OCT-GPA were included. Three different baseline conditions were created by dividing eight serial OCT tests from each eye into three sets. Specifically, these sets presented baseline tests at exams 1-2 (1st set), 2-3 (2nd set) and 3-4 (3rd set), respectively. Agreement on progression detection was defined as the presence of 'Possible Loss' or 'Likely Loss' in the 2nd or 3rd sets at the same location in the 1st set.
The proportion of eyes with agreement on progression detection was 47.1%, 20.0% and 31.0% for RNFL 'thickness map progression', 'thickness profiles progression' and 'average thickness progression', respectively. In GCIPL 'thickness map progression' and 'average thickness progression', 53.8% and 62.8% of eyes showed agreement, respectively. Eyes with disagreement showed a greater change in thickness (slope of change in the 3rd set-1st set) compared to the eyes with agreement (p<0.05), with the exception of RNFL 'thickness profiles progression' (p=0.064).
Glaucoma progression detection by OCT-GPA was affected by baseline test selection, especially in eyes with a greater reduction in progression. GCIPL thickness was less influenced by baseline test selection compared to RNFL thickness.
通过光学相干断层扫描（OCT）引导的进展分析（GPA），评估基线测试选择对青光眼患者视盘周围视网膜神经纤维层（RNFL）和黄斑神经节细胞 - 内丛状层（GCIPL）进展检测的影响。
共纳入53只使用OCT - GPA确定有RNFL或GCIPL进展的眼睛。通过将每只眼睛的八次连续OCT测试分为三组，创建了三种不同的基线条件。具体而言，这些组分别在第1 - 2次检查（第1组）、第2 - 3次检查（第2组）和第3 - 4次检查（第3组）时呈现基线测试。进展检测的一致性定义为第2组或第3组中与第1组相同位置存在“可能损失”或“可能损失”。
对于RNFL“厚度图进展”、“厚度剖面图进展”和“平均厚度进展”，进展检测一致的眼睛比例分别为47.1%、20.0%和31.0%。在GCIPL“厚度图进展”和“平均厚度进展”中，分别有53.8%和62.8%的眼睛显示出一致性。与进展检测一致的眼睛相比，进展检测不一致的眼睛厚度变化更大（第3组 - 第1组的变化斜率）（p<0.05），RNFL“厚度剖面图进展”除外（p = 0.064）。
OCT - GPA检测青光眼进展受基线测试选择的影响，尤其是在进展减少较大的眼睛中。与RNFL厚度相比，GCIPL厚度受基线测试选择的影响较小。
