Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia.
Department of Ophthalmology, Flinders University, Adelaide, South Australia, Australia.
Clin Exp Ophthalmol. 2020 Sep;48(7):915-926. doi: 10.1111/ceo.13826. Epub 2020 Aug 14.
Glaucoma progression rates may differ depending on the retinal structural parameters measured, and between devices.
To compare retinal nerve fibre layer (RNFL) and ganglion cell/inner plexiform layers (GCL/IPL) progression rates using two spectral-domain optical coherence tomography (OCT) systems.
Prospective, university hospital setting.
Cross-sectional study: 100 eyes from 53 glaucoma suspects and early manifest glaucoma cases. Longitudinal study: subset of 61 eyes from 33 participants.
Same day optic nerve and macular images were acquired using Cirrus and Spectralis systems from which RNFL and GCL/IPL thicknesses were calculated. Longitudinal analysis of RNFL and GCL/IPL progression rates was calculated from 6 × 6-monthly follow-up OCT scans.
RNFL and GCL/IPL thicknesses in matched superior, inferior and global regions were compared by both systems cross-sectionally and longitudinally.
At baseline, no RNFL thicknesses differed between devices. Cirrus GCL/IPL regions were significantly thicker than Spectralis (P < .001). RNFL and GCL/IPL global progression rates (μm/y) had a mean (SD) of -1.28 (1.11) and 95% CI: (-1.48, -1.09) and -0.51 (0.58) and 95% CI: (-0.62, -0.41), respectively. Progression rates were similar across devices. RNFL loss (%) progressed significantly faster than GCL/IPL, in all regions (P ≤ .004).
Despite baseline thickness differences, overall Cirrus and Spectralis provided similar rates of RNFL and GCL/IPL progression in early glaucoma and can be considered comparable, though not interchangeable, in clinical practice. Further analysis is needed to determine if RNFL progresses faster than GCL/IPL in glaucoma, and whether one precedes the other.
青光眼的进展速度可能因所测量的视网膜结构参数和设备的不同而有所差异。
使用两种谱域光学相干断层扫描（OCT）系统比较视网膜神经纤维层（RNFL）和节细胞/内丛状层（GCL/IPL）的进展速度。
前瞻性、大学医院环境。
横断面研究：53 名青光眼疑似患者和早期显性青光眼患者的 100 只眼。纵向研究：33 名参与者中的 61 只眼的子样本。
同一天使用 Cirrus 和 Spectralis 系统获取视神经和黄斑图像，并计算 RNFL 和 GCL/IPL 厚度。从 6 次每 6 个月的 OCT 扫描中计算出 RNFL 和 GCL/IPL 进展率的纵向分析。
通过两种系统分别进行横断面和纵向比较匹配的上、下和全局区域的 RNFL 和 GCL/IPL 厚度。
在基线时，两种设备之间的 RNFL 厚度没有差异。Cirrus 的 GCL/IPL 区域明显比 Spectralis 厚（P<0.001）。RNFL 和 GCL/IPL 全局进展率（μm/y）的平均值（标准差）分别为-1.28（1.11）和 95%可信区间：（-1.48，-1.09）和-0.51（0.58）和 95%可信区间：（-0.62，-0.41）。两种设备的进展率相似。在所有区域，RNFL 损失（%）的进展速度都明显快于 GCL/IPL（P≤0.004）。
尽管存在基线厚度差异，但 Cirrus 和 Spectralis 整体上在早期青光眼患者中提供了相似的 RNFL 和 GCL/IPL 进展速度，可以认为在临床实践中是可比较的，尽管不能互换。需要进一步分析以确定在青光眼患者中，RNFL 是否比 GCL/IPL 进展更快，以及哪一个先发生。
