Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Novo Research Consultancy, Voorburg, The Netherlands.
Transl Vis Sci Technol. 2022 May 2;11(5):20. doi: 10.1167/tvst.11.5.20.
To determine the sensitivity of optical coherence tomography (OCT) and standard automated perimetry (SAP) for detecting glaucomatous progression in the superior and inferior hemiretina.
We calculated contrast-to-noise ratios (CNRs) for OCT retinal nerve fiber layer (RNFL) thickness of hemiretinas and for SAP mean total deviation (MTD) of the corresponding hemifields from longitudinal data (205 eyes, 125 participants). The glaucoma stage for each hemiretina was based on the corresponding hemifield's MTD. Contrast was defined as the difference of the parameter between two consecutive glaucoma stages, whereas noise was the measurement variability of the parameter in those stages. The higher the CNR of a parameter, the more sensitive it is to detecting progression in the transition between successive stages.
There were no statistically significant differences for the RNFL CNR and MTD CNR between superior and inferior hemiretinas. As the glaucoma stage of the opposite hemiretina worsened, the MTD CNR in the transition from moderate to advanced glaucoma significantly increased. The RNFL CNR in the transition from mild to moderate glaucoma significantly decreased in case of advanced glaucoma in the opposite hemiretina.
Similar to full retinas, detecting conversion to glaucoma in hemiretinas is more sensitive with OCT than SAP, whereas with more advanced disease, SAP is more sensitive for detecting progression. More importantly, the sensitivity for detecting progression in one hemiretina with either technique depends on the glaucoma severity in the opposite hemiretina.
Monitoring glaucomatous progression with either OCT or SAP partly depends on the glaucoma severity in the opposite hemiretina.
确定光学相干断层扫描（OCT）和标准自动视野计（SAP）检测上、下半视网膜青光眼进展的敏感性。
我们从纵向数据（205 只眼，125 名参与者）计算了 OCT 视网膜神经纤维层（RNFL）厚度和 SAP 相应半视野平均总偏差（MTD）的半视网膜对比噪声比（CNR）。每个半视网膜的青光眼分期基于相应半视野的 MTD。对比定义为两个连续青光眼分期之间参数的差异，而噪声是这些分期中参数的测量变异性。参数的 CNR 越高，其在连续阶段之间的进展检测中就越敏感。
上、下半视网膜的 RNFL CNR 和 MTD CNR 之间没有统计学上的显著差异。随着对侧半视网膜青光眼分期的恶化，从中度到进展期青光眼的过渡中 MTD CNR 显著增加。在对侧半视网膜为进展性青光眼的情况下，从轻度到中度青光眼的过渡中 RNFL CNR 显著降低。
与全视网膜一样，OCT 检测半视网膜青光眼进展的敏感性优于 SAP，而在更晚期疾病中，SAP 检测进展的敏感性更高。更重要的是，任何一种技术检测一只半视网膜进展的敏感性取决于对侧半视网膜的青光眼严重程度。
杨超
