Kim Yong Hyun, Ahn Jaehong, Kim Ko Eun
Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.
Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.; Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Am J Ophthalmol. 2022 Feb;234:147-155. doi: 10.1016/j.ajo.2021.07.022. Epub 2021 Jul 25.
To investigate the diagnostic performance of multicolor imaging for detection of retinal nerve fiber layer (RNFL) defects in myopic eyes with glaucoma.
Comparative diagnostic analysis.
A total of 150 myopic eyes of 138 patients (< -1.00 diopter or axial length >24 mm) underwent multicolor imaging by Spectralis (Heidelberg Engineering GmbH) optical coherence tomography (OCT). Two independent observers graded the RNFL visibility score and determined the location of the RNFL defect on each image. Readings were taken from the superior and inferior areas. The diagnostic performances of multicolor, green-reflectance, and blue-reflectance images for detection of the RNFL defect were compared with those of conventional fundus and red-free RNFL photographs.
The interobserver agreement on the RNFL visibility score was substantial for fundus and RNFL photographs and multicolor and green-reflectance images and was perfect for blue-reflectance images. The interobserver agreement on the location of the RNFL defect was better when using multicolor imaging than when using conventional photography. The green-reflectance image (2.89 ± 0.31) showed the highest RNFL visibility score, followed by blue-reflectance (2.88 ± 0.32) and multicolor (2.57 ± 0.63) images. The sensitivity of multicolor imaging (94.9%, 93.2%, and 91.5% for green-reflectance, blue-reflectance, and multicolor images, respectively) was significantly higher than that of fundus photography (83.1%) for detection of superotemporal RNFL defects (all P < .05). It was significantly higher for inferotemporal defects than those of fundus and RNFL photographs (all P < .05).
Multicolor imaging can visualize the glaucomatous RNFL defects in myopic eyes that are indistinguishable on conventional photography.
研究多色成像技术在检测青光眼性近视眼视网膜神经纤维层（RNFL）缺损方面的诊断性能。
对比诊断分析。
138例患者的150只近视眼（屈光度＜-1.00或眼轴长度＞24mm）接受了海德堡工程有限公司Spectralis光学相干断层扫描（OCT）的多色成像检查。两名独立观察者对每张图像上的RNFL可见度评分并确定RNFL缺损的位置。测量区域为上方和下方区域。将多色、绿色反射和蓝色反射图像检测RNFL缺损的诊断性能与传统眼底和无赤光RNFL照片的诊断性能进行比较。
观察者间对眼底和RNFL照片、多色和绿色反射图像的RNFL可见度评分一致性良好，对蓝色反射图像的一致性极佳。使用多色成像时，观察者间对RNFL缺损位置的一致性优于传统摄影。绿色反射图像（2.89±0.31）的RNFL可见度评分最高，其次是蓝色反射图像（2.88±0.32）和多色图像（2.57±0.63）。在检测颞上象限RNFL缺损方面，多色成像的敏感度（绿色反射、蓝色反射和多色图像分别为94.9%、93.2%和91.5%）显著高于眼底摄影（83.1%）（所有P＜0.05）。在检测颞下象限缺损方面，多色成像的敏感度显著高于眼底和RNFL照片（所有P＜0.05）。
多色成像能够显示在传统摄影中难以区分的青光眼性近视眼RNFL缺损。
