Ophthalmology, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden.
Ophthalmology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
Acta Ophthalmol. 2021 May;99(3):260-268. doi: 10.1111/aos.14553. Epub 2020 Aug 9.
To compare the effects of ageing and glaucoma progression on the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and to evaluate the performance of a set of optical coherence tomography (OCT) progression analyses.
The cpRNFL was measured twice by OCT at each of two visits made 10 years apart in 69 healthy individuals and 49 glaucoma patients. Both visits also included Humphrey 24-2 SITA standard testing. The change in cpRNFL thickness was analysed by linear regression, and a sub-analysis was performed on glaucoma patients with a perimetric mean deviation better than -10 dB at the first visit. The proportion of individuals whose OCT progression analyses indicated progression was also evaluated for the same groups.
The average cpRNFL thickness deteriorated by a mean of -0.16 μm/year in the healthy cohort, increased by 0.03 μm/year in the glaucoma cohort, and deteriorated by -0.24 μm/year in eyes with less severe glaucoma; there were no statistically significant differences between the groups. For 17 (30%) of 56 healthy individuals, at least one of the three different OCT progression analyses incorrectly indicated progression.
No significant differences in change of cpRNFL thickness between visits were found when comparing healthy subjects with glaucoma patients. Also, further cpRNFL thinning was not observed in glaucomatous eyes in which at least one-third of the visual field had been lost. The OCT progression analyses generated a relatively high proportion of false positives. Using OCT for glaucoma follow-up may not be entirely straightforward.
比较年龄增长和青光眼进展对视神经纤维层（cpRNFL）厚度的影响，并评估一组光学相干断层扫描（OCT）进展分析的性能。
在 69 名健康个体和 49 名青光眼患者的两次随访中，通过 OCT 两次测量 cpRNFL 的厚度，每次随访相隔 10 年。两次随访均包括 Humphrey 24-2 SITA 标准测试。通过线性回归分析 cpRNFL 厚度的变化，并对第一次随访时平均缺损值优于-10dB 的青光眼患者进行亚组分析。还评估了相同组中个体的 OCT 进展分析表明进展的比例。
健康队列中 cpRNFL 平均厚度每年恶化-0.16μm，青光眼队列中每年增加 0.03μm，较不严重的青光眼患者每年恶化-0.24μm；各组之间无统计学差异。在 56 名健康个体中，有 17 名（30%）至少有三种不同的 OCT 进展分析之一错误地表明进展。
在比较健康受试者和青光眼患者时，两次随访中 cpRNFL 厚度的变化没有显著差异。此外，在至少三分之一的视野已经丧失的青光眼眼中，没有观察到 cpRNFL 的进一步变薄。OCT 进展分析产生了相对较高比例的假阳性。使用 OCT 进行青光眼随访可能并不完全简单。
