Tajimi Iwase Eye Clinic, Tajimi, Gifu Prefecture.
Department of Ophthalmology, University of the Ryukyus Graduate School of Medicine, Nishihara, Okinawa Prefecture.
J Glaucoma. 2022 Apr 1;31(4):228-234. doi: 10.1097/IJG.0000000000001960.
The inferior>superior>temporal rim width rate (IST pattern) rather than inferior≥superior≥nasal≥temporal (ISNT) pattern was suited for screening glaucoma in Japanese subjects. Failure of the IST pattern was associated with several important risk factors for glaucoma.
The purpose of this study was to find a rim width rate pattern to yield the highest positive likelihood ratio (LR+) in detecting glaucoma eyes and to identify risk factors for glaucoma correlating with its failure in a population-based setting.
Disc stereophotographs of 2474 eyes of 2474 normal subjects and 237 eyes of 237 glaucoma subjects found in the Kumejima Study were analyzed using computer-assisted planimetry. Among all combinations of the inferior (I), superior (S), nasal (N) and/or temporal (T) rim width rate, a pattern showing the highest LR+ was selected and risk factors for glaucoma correlating with its failure were determined using multiple logistic regression analysis.
The average I, S, N, and T rim widths (SD) were 0.45 (0.10), 0.39 (0.09), 0.47 (0.11), and 0.27 (0.07) mm. Among all combinations, the I>S>T rim width rate pattern (IST pattern) disregarding the N rim width showed the highest LR+ of 2.002 (95% confidence interval, 1.778-2.253). Failure of the IST pattern in normal eyes correlated with a smaller disc area (P<0.001) and disc ovality (P=0.005) and larger β-peripapillary area (P<0.001) and compliance with in glaucoma eyes with a smaller β-PPA area (P=0.027), thicker central corneal thickness (P=0.017), lower intraocular pressure (P=0.019), and higher body mass index (P=0.037).
Among all combinations, the I>S>T rim width pattern, the IST pattern, yielded the highest LR+ in detecting glaucoma in Japanese glaucoma eyes and its failure of or compliance with the pattern significantly correlated with several known risk factors for glaucoma.
在下>上>颞侧边缘宽度比（IST 模式），而不是下≥上≥鼻侧≥颞侧（ISNT）模式，更适合于筛查日本人群中的青光眼。IST 模式的失败与青光眼的几个重要危险因素有关。
本研究旨在找到一种边缘宽度比模式，以获得最高的阳性似然比（LR+），用于检测青光眼，并在基于人群的研究中确定与该模式失败相关的与青光眼相关的危险因素。
使用计算机辅助平面测量法对 2474 名正常受试者的 2474 只眼和 237 名青光眼受试者的 237 只眼的眼底立体照片进行分析。在所有下（I）、上（S）、鼻（N）和/或颞（T）边缘宽度比的组合中，选择显示最高 LR+的模式，并使用多变量逻辑回归分析确定与该模式失败相关的青光眼危险因素。
平均 I、S、N 和 T 边缘宽度（标准差）分别为 0.45（0.10）、0.39（0.09）、0.47（0.11）和 0.27（0.07）mm。在所有组合中，不考虑 N 边缘宽度的 I>S>T 边缘宽度比模式（IST 模式）显示出最高的 LR+为 2.002（95%置信区间，1.778-2.253）。在正常眼中，IST 模式的失败与较小的视盘面积（P<0.001）和视盘椭圆度（P=0.005）以及较大的β-视盘旁面积（P<0.001）和在青光眼眼中与较小的β-PPA 面积（P=0.027）、较厚的中央角膜厚度（P=0.017）、较低的眼压（P=0.019）和较高的体重指数（P=0.037）相关。
在所有组合中，I>S>T 边缘宽度比模式，即 IST 模式，在检测日本青光眼眼中的青光眼时产生了最高的 LR+，其模式的失败或符合显著与青光眼的几个已知危险因素相关。
