Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain.
Eur J Ophthalmol. 2021 Nov;31(6):3476-3482. doi: 10.1177/1120672120986374. Epub 2021 Jan 12.
To evaluate the efficacy of Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT) in differentiating between optic nerve head drusen (ONHD) and optic disc oedema (ODE).
This was a cross-sectional study of 140 patients: 83 patients with ONHD (49 hidden and 34 visible), 20 patients with pseudopapilloedema (without drusen), and 37 patients with ODE. EDI-OCT of the optic nerve was performed, selecting one high-resolution line from the HD 5-line raster protocol. Two observers blindly evaluated the presence of a hyporeflective core surrounded by a hyperreflective margin or border. The sensitivity, specificity, predictive values and posttest probability were evaluated as well as the inter-observer agreement (k).
EDI-OCT demonstrated a sensitivity of 92% (95% CI: 83%-96%), a specificity of 96% (95% CI: 87%-99%), with a positive predictive value of 97% and a negative predictive value of 89%. The inter-observer agreement was as remarkable as = 0.8985 (95% CI 0.8252-0.9718). A positive EDI OCT increases the posttest probability to 97% (95% CI: 91%-99%); when negative, the posttest probability is reduced to 12% (95% CI: 6%-21%).
EDI-OCT allowed for differentiation between ONHD and ODE with high sensitivity and specificity.
评估增强深度成像光相干断层扫描（EDI-OCT）在鉴别视神经头玻璃膜疣（ONHD）和视盘水肿（ODE）中的疗效。
这是一项横断面研究，共纳入 140 名患者：83 名 ONHD 患者（49 名隐匿性，34 名显性），20 名假性视乳头水肿患者（无玻璃膜疣）和 37 名 ODE 患者。对视神经进行 EDI-OCT 检查，从 HD 5 线光栅方案中选择一条高分辨率线。两名观察者盲法评估低反射核心伴高反射边缘或边界的存在。评估了敏感性、特异性、预测值和后验概率以及观察者间一致性（k）。
EDI-OCT 显示出 92%（95%CI：83%-96%）的敏感性、96%（95%CI：87%-99%）的特异性、97%的阳性预测值和 89%的阴性预测值。观察者间的一致性非常显著，k 值为 0.8985（95%CI 0.8252-0.9718）。阳性 EDI-OCT 将后验概率提高到 97%（95%CI：91%-99%）；阴性时，后验概率降低至 12%（95%CI：6%-21%）。
EDI-OCT 能够以较高的敏感性和特异性鉴别 ONHD 和 ODE。
