Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (T.dS.A., A.A.dN.R., L.G.M.M., L.P.C., M.L.R.M), University of São Paulo Medical School, São Paulo, Brazil.
Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte (R.B.dA.), Brazil.
Am J Ophthalmol. 2022 Feb;234:156-165. doi: 10.1016/j.ajo.2021.08.008. Epub 2021 Aug 25.
To compare optical coherence tomography-measured Bruch membrane opening minimum rim width (MRW), peripapillary retinal nerve fiber layer (pRNFL) measurements, and MRW:pRNFL ratios in eyes with compressive optic neuropathy (CON) and glaucoma and controls, and evaluate the ability of these parameters to differentiate CON from glaucoma.
Prospective, cross-sectional study.
Setting: Single-center tertiary hospital and outpatient clinic.
One hundred fifteen eyes of 77 participants, 34 with CON from chiasmal lesions, 21 with glaucoma, and 22 healthy controls.
Optical coherence tomography-measured MRW, pRNFL, and MRW:pRNFL ratios for each optic disc sector and global average.
MRW, pRNFL, and MRW:pRNFL ratios compared using generalized estimated equations. Area under the receiver operating characteristic curve and positive and negative likelihood ratios were calculated.
MRW and pRNFL measurements were significantly reduced in CON and glaucoma compared with controls. In glaucoma, MRW was thinner than in CON in the global, inferotemporal, superonasal, inferonasal, and vertical average measurements, but a significant overlap was observed in many parameters. MRW:pRNFL ratios increased the ability to discriminate between CON and glaucoma, as shown by the high area under the receiver operating characteristic curve, high positive likelihood ratios, and low negative likelihood ratios, especially in the nasal disc sector and the nasal and temporal average.
MRW measurements alone cannot reliably distinguish CON from glaucoma, but the combination of MRW, pRNFL, and MRW:pRNFL ratios significantly improves accuracy. When comparing the 2 conditions, MRW:pRNFL ratios yielded higher area under the receiver operating characteristic curve and positive and negative likelihood ratios, suggesting this parameter may be helpful in clinical practice.
比较压迫性视神经病变（CON）和青光眼患者与对照组的光学相干断层扫描测量的脉络膜开口最小边缘宽度（MRW）、视盘周围视网膜神经纤维层（pRNFL）测量值和 MRW:pRNFL 比值，并评估这些参数区分 CON 与青光眼的能力。
前瞻性、横断面研究。
地点：单中心三级医院和门诊。
77 名参与者的 115 只眼，34 只为视交叉病变所致 CON，21 只为青光眼，22 只为健康对照组。
对每个视盘扇区和全局平均值进行光学相干断层扫描测量的 MRW、pRNFL 和 MRW:pRNFL 比值。
使用广义估计方程比较 MRW、pRNFL 和 MRW:pRNFL 比值。计算曲线下面积和阳性及阴性似然比。
CON 和青光眼组的 MRW 和 pRNFL 测量值均显著低于对照组。在青光眼组中，与 CON 相比，全局、下颞、上鼻、下鼻和垂直平均值的 MRW 更薄，但许多参数仍存在显著重叠。MRW:pRNFL 比值增加了区分 CON 和青光眼的能力，表现为曲线下面积高、阳性似然比高、阴性似然比低，尤其是在鼻盘区和鼻侧及颞侧平均值。
仅 MRW 测量值不能可靠地区分 CON 与青光眼，但 MRW、pRNFL 和 MRW:pRNFL 比值的组合显著提高了准确性。在比较这两种情况时，MRW:pRNFL 比值产生了更高的曲线下面积和阳性及阴性似然比，表明该参数在临床实践中可能具有一定的帮助。
