Wang Geng, Zhen Miaoru, Liu Shasha, Qiu Kunliang, Liu Cui, Wang Ji, Zhang Mingzhi
Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Front Med (Lausanne). 2021 Aug 25;8:729523. doi: 10.3389/fmed.2021.729523. eCollection 2021.
This study was conducted in order to compare the diagnostic classification of Bruch's membrane opening-minimum rim width (BMO-MRW) and RNFL thickness in normal myopic subjects by using optical coherence tomography (OCT). This cross-sectional study involved 75 healthy myopic subjects [spherical equivalent (SE) ≤ -0.5D] from April 2019 to January 2020. One eye of each subject was randomly selected for examination. BMO-MRW and peripapillary RNFL thickness were measured by spectral-domain OCT (Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany). All the subjects were divided into three groups: low myopic group (SE > -3D), moderate myopic group (-6D < SE ≤ -3D), and high myopic group (SE ≤ -6D). A nonparametric test was used to analyze the difference among groups. Linear regression was used to analyze the relationship between BMO-MRW/RNFL thickness and axial length/spherical equivalent. McNemar test was used to compare the diagnostic classification between BMO-MRW and RNFL thickness. The RNFL thickness classified a significantly higher percentage of eyes as outside normal limits/borderline in at least 1 quadrant (BMO-MRW, 4%; RNFL thickness, 34.67%; < 0.01). There was no significant correlation between BMO-MRW/RNFL thickness and AL/SE. The low myopia (SE > -3D) had a significantly lower percentage of eyes classified as outside normal limits/borderline in at least 1 quadrant than the moderate myopia (-6D < SE ≤ -3D) and high myopia (SE ≤ -6D) (low myopia, 12.5%; moderate/high myopia, 42.42%/50%; < 0.05). BMO-MRW had a lower percentage of eyes classified as outside normal limits/borderline in at least 1 quadrant than RNFL thickness in normal myopic subjects. When referring to the diagnostic classification of RNFL thickness in myopic subjects, caution should be exercised in interpreting positive results. Further studies are needed to compare the diagnostic accuracy of these two measurements in myopic glaucoma patients.
本研究旨在通过光学相干断层扫描（OCT）比较正常近视受试者中布鲁赫膜开口最小边缘宽度（BMO-MRW）和视网膜神经纤维层（RNFL）厚度的诊断分类。这项横断面研究纳入了2019年4月至2020年1月期间的75名健康近视受试者[等效球镜度数（SE）≤-0.5D]。为每名受试者随机选择一只眼睛进行检查。采用谱域OCT（德国海德堡海德堡工程有限公司的Spectralis）测量BMO-MRW和视乳头周围RNFL厚度。所有受试者被分为三组：低度近视组（SE＞-3D）、中度近视组（-6D＜SE≤-3D）和高度近视组（SE≤-6D）。采用非参数检验分析组间差异。采用线性回归分析BMO-MRW/RNFL厚度与眼轴长度/等效球镜度数之间的关系。采用McNemar检验比较BMO-MRW和RNFL厚度的诊断分类。RNFL厚度将至少1个象限超出正常范围/临界值的眼睛分类的比例显著更高（BMO-MRW为4%；RNFL厚度为34.67%；P＜0.01）。BMO-MRW/RNFL厚度与眼轴长度/等效球镜度数之间无显著相关性。低度近视（SE＞-3D）至少1个象限超出正常范围/临界值的眼睛分类比例显著低于中度近视（-6D＜SE≤-3D）和高度近视（SE≤-6D）（低度近视，12.5%；中度/高度近视，42.42%/50%；P＜0.05）。在正常近视受试者中，BMO-MRW至少1个象限超出正常范围/临界值的眼睛分类比例低于RNFL厚度。在参考近视受试者RNFL厚度的诊断分类时，对阳性结果的解读应谨慎。需要进一步研究比较这两种测量方法在近视性青光眼患者中的诊断准确性。
