Smt Jadhavabhai Nathamal Singhvee Glaucoma Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2021 Mar;69(3):603-610. doi: 10.4103/ijo.IJO_1309_20.
The aim of this study was to compare SD-OCT parameters between disc suspects and "pre-perimetric" glaucomatous discs classified on disc photos.
Disc photos of suspicious discs with normal Humphrey visual fields (HVF) were graded as normal or pre-perimetric glaucomatous based on the consensus of three masked glaucoma specialists. RNFL and GCL-IPL maps of SD-OCT (Cirrus OCT) of these eyes were studied. Quantitative RNFL parameters were compared. Both groups were also compared with respect to parameters being classified as abnormal (at the 1% level), and the pattern of GCL-IPL and NFL maps were assessed qualitatively and classified as normal or pre-perimetric glaucomatous by a masked glaucoma specialist.
The average and inferior RNFL thicknesses were decreased in pre-perimetric glaucomatous eyes compared to normal eyes (p 0.01) The average, minimal, inferotemporal and inferior sector GCL-IPL thicknesses were decreased in pre-perimetric glaucomatous eyes (all P < 0.002) The highest AUC was for the inferior RNFL thickness (0.771) followed by average RNFL thickness (0.757) The sensitivity and specificity for any one abnormal RNFL parameter was 71.9% and 59.7%, for GCL-IPL parameters was 70% and 69.1% The positive (PLR) and negative likelihood ratios (NLR) were 1.78 and 0.47 for RNFL and 2.26 and 0.43 for GCL-IPL parameters. For the qualitative assessment of RNFL and GCL-IPL maps, the sensitivity, specificity, PLR and NLR were 75%, 77.2%, 3.29, and 0.32, respectively.
Pre-perimetric disc suspects had greater OCT changes compared to normal disc suspects. Qualitative assessment of RNFL and GCL-IPL maps had the highest discriminatory ability.
本研究旨在比较基于盘照片分类的视盘可疑者和“超阈值”青光眼盘的 SD-OCT 参数。
根据三位盲法青光眼专家的共识，对具有正常 Humphrey 视野（HVF）的可疑盘的盘照片进行分级，分为正常或超阈值青光眼。研究了这些眼的 SD-OCT（Cirrus OCT）的 RNFL 和 GCL-IPL 图。比较了定量 RNFL 参数。还比较了两组参数异常（1%水平）的情况，并由一位盲法青光眼专家对 GCL-IPL 和 NFL 图的模式进行定性评估，并分类为正常或超阈值青光眼。
与正常眼相比，超阈值青光眼眼的平均和下方 RNFL 厚度降低（p<0.01）。超阈值青光眼眼的平均、最小、下颞侧和下方 GCL-IPL 厚度均降低（均 P<0.002）。最低的 AUC 为下方 RNFL 厚度（0.771），其次是平均 RNFL 厚度（0.757）。任何一个异常 RNFL 参数的敏感性和特异性分别为 71.9%和 59.7%，GCL-IPL 参数分别为 70%和 69.1%。阳性（PLR）和阴性似然比（NLR）分别为 1.78 和 0.47，用于 RNFL 和 2.26 和 0.43，用于 GCL-IPL 参数。对于 RNFL 和 GCL-IPL 图的定性评估，敏感性、特异性、PLR 和 NLR 分别为 75%、77.2%、3.29 和 0.32。
与正常视盘可疑者相比，超阈值视盘可疑者的 OCT 变化更大。RNFL 和 GCL-IPL 图的定性评估具有最高的鉴别能力。
