Li Yan-Jie, Liu Wei-Shai, Bai Zi-Chao, Cao Rong-Xia, Ren Hai-Hua
Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Int J Ophthalmol. 2020 Dec 18;13(12):1915-1921. doi: 10.18240/ijo.2020.12.11. eCollection 2020.
To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma (POAG) by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to evaluate the diagnostic value of OCT and OCTA.
Totally 15 patients (23 eyes) with early POAG as observation group and 30 health people (30 eyes) as normal control group were enrolled in this cross-sectional study. OCTA-based superficial macula vessel density, superficial macula perfusion density, superficial optic disc vessel density, superficial optic disc perfusion density and spectral domain OCT (SD-OCT)-based macular area thickness, ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness were measured in the two groups. Independent -test and receiver operating characteristic curve were used for analysis. Area under the receiver operating characteristic curves (AUROC) were used to measure the diagnostic utility.
Among all the parameters, the optimal diagnostic utility parameter was the superficial vessel density in the macular area (except the center of the macula), and the AUROC reached 0.98. The diagnostic utility of macular area perfusion density (except the center of the macula) was similar to that of superficial vessel density in the macular area, and the AUROC was above 0.97. Followed by the diagnostic utility of vessel density in the optic disc area, the best parameter was the inner ring of the vessel density, and its AUROC reached 0.97. The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area. The best parameter was the central optic disc perfusion density, and its AUROC was 0.95. The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above, the top three parameters were the inferior RNFL thickness (AUROC=0.919), the superior (AUROC=0.919) and the inferior GCC thickness (AUROC=0.9077).
The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters. OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.
采用光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）观察并描述60岁以下早期原发性开角型青光眼（POAG）患者黄斑区和视盘区的影像学特征，并评估OCT和OCTA的诊断价值。
本横断面研究纳入15例（23只眼）早期POAG患者作为观察组，30例健康人（30只眼）作为正常对照组。测量两组基于OCTA的黄斑区表层血管密度、黄斑区表层灌注密度、视盘区表层血管密度、视盘区表层灌注密度，以及基于谱域OCT（SD-OCT）的黄斑区厚度、神经节细胞复合体（GCC）厚度和视网膜神经纤维层（RNFL）厚度。采用独立样本t检验和受试者工作特征曲线进行分析。用受试者工作特征曲线下面积（AUROC）衡量诊断效能。
所有参数中，最佳诊断效能参数为黄斑区（黄斑中心除外）表层血管密度，AUROC达0.98。黄斑区灌注密度（黄斑中心除外）的诊断效能与黄斑区表层血管密度相似，AUROC高于0.97。其次是视盘区血管密度的诊断效能，最佳参数为血管密度内环，其AUROC达0.97。视盘区灌注密度的诊断效能略低于视盘区血管密度。最佳参数为视盘中央灌注密度，其AUROC为0.95。基于SD-OCT的诊断效能参数普遍低于上述参数，前三位参数为下方RNFL厚度（AUROC=0.919）、上方（AUROC=0.919）和下方GCC厚度（AUROC=0.9077）。
基于OCT的诊断效能参数普遍低于基于OCTA的诊断效能参数。OCTA在60岁以下早期POAG患者的诊断和评估中具有重要的临床应用价值。
