Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.
Nat Biomed Eng. 2022 May;6(5):593-604. doi: 10.1038/s41551-021-00813-x. Epub 2022 Jan 6.
The clinical diagnostic evaluation of optic neuropathies relies on the analysis of the thickness of the retinal nerve fibre layer (RNFL) by optical coherence tomography (OCT). However, false positives and false negatives in the detection of RNFL abnormalities are common. Here we show that an algorithm integrating measurements of RNFL thickness and reflectance from standard wide-field OCT scans can be used to uncover the trajectories and optical texture of individual axonal fibre bundles in the retina and to discern distinctive patterns of loss of axonal fibre bundles in glaucoma, compressive optic neuropathy, optic neuritis and non-arteritic anterior ischaemic optic neuropathy. Such optical texture analysis can detect focal RNFL defects in early optic neuropathy, as well as residual axonal fibre bundles in end-stage optic neuropathy that were indiscernible by conventional OCT analysis and by red-free RNFL photography. In a diagnostic-performance study, optical texture analysis of the RNFL outperformed conventional OCT in the detection of glaucoma, as defined by visual-field testing or red-free photography. Our findings show that optical texture analysis of the RNFL for the detection of optic neuropathies is highly sensitive and specific.
视神经病变的临床诊断评估依赖于光学相干断层扫描（OCT）对视网膜神经纤维层（RNFL）厚度的分析。然而，RNFL 异常的检测中经常出现假阳性和假阴性。在这里，我们展示了一种算法，该算法可以整合 RNFL 厚度的测量值和标准宽场 OCT 扫描的反射率，用于揭示视网膜中单个轴突纤维束的轨迹和光学纹理，并识别青光眼、压迫性视神经病变、视神经炎和非动脉炎性前部缺血性视神经病变中轴突纤维束丢失的独特模式。这种光学纹理分析可以检测早期视神经病变中的局灶性 RNFL 缺陷，以及传统 OCT 分析和无赤光 RNFL 摄影无法识别的晚期视神经病变中的残余轴突纤维束。在一项诊断性能研究中，基于视野测试或无赤光摄影的定义，RNFL 的光学纹理分析在青光眼检测方面优于传统 OCT。我们的研究结果表明，用于检测视神经病变的 RNFL 光学纹理分析具有高度的敏感性和特异性。
