Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India.
Sathyan Eye Care Hospital & Coimbatore Glaucoma Foundation, Coimbatore, Tamil Nadu, India.
Indian J Ophthalmol. 2022 Jun;70(6):2211. doi: 10.4103/ijo.IJO_1261_21.
Traditional methods for neuroretinal rim width measurement in spectral domain optical coherence tomography (SD-OCT) employs the Bruch's membrane opening (BMO) as the anatomical border of the rim, referenced to a BMO horizontal reference plane, termed as "Bruch's Membrane Opening-Horizontal Rim Width" (BMO-HRW). BMO-HRW is defined as the distance between BMO and internal limiting membrane (ILM) on the horizontal plane. In contrast, the Spectralis OCT (Heidelberg Engineering, Germany) employs a new parameter called "Bruch's Membrane Opening-Minimum Rim Width" (BMO-MRW) with Glaucoma Module Premium Edition (GMPE). GMPE provides a novel objective method of optic nerve head (ONH) analysis using BMO, but the neuroretinal rim assessment is performed from the BMO to the nearest point on the ILM, rather than on the horizontal reference plane. It is the BMO-MRW and is defined as the minimum distance between the BMO and ILM in the ONH.
In this video, anatomy of the ONH and GMPE is decoded from a neophyte user's point of view, as to why BMO-MRW is more important than the traditional BMO-HRW for glaucoma evaluation.
The GMPE concepts are depicted in a novel dynamic (Clinical vs OCT Vs Histology) screenplay, detailing the below focal points with 2D & 3D animations: True Margin of ONH, Bruch's Membrane (BM), Histology Vs OCT, BMO, Bruch's Membrane Opening-Minimum Rim Width, Bruch's Membrane Opening-Minimum Rim Width Versus Bruch's Membrane Opening-Horizontal Rim Width, Alpha, Beta, Gamma Zone of ONH in OCT, Anatomic Positioning System, Impact of Fovea Bruch's Membrane Opening Centre Axis.
This video also highlights, how with the advent of Anatomic Positioning System, scans were able to align relative to the individual's Fovea-to-BMO-center (FoBMOC) axis at every follow-up, for accurately detecting changes, as small as 1 micron in BMO-MRW, thus creating a new world in diagnosing glaucoma and detecting glaucomatous progression with precision.
在频域光学相干断层扫描（SD-OCT）中，传统的神经视网膜边缘宽度测量方法使用 Bruch 膜开口（BMO）作为边缘的解剖边界，参考水平的 BMO 参考平面，称为“Bruch 膜开口-水平边缘宽度”（BMO-HRW）。BMO-HRW 定义为 BMO 与水平面上的内界膜（ILM）之间的距离。相比之下，Spectralis OCT（德国海德堡工程公司）使用一种新的参数，称为“Bruch 膜开口-最小边缘宽度”（BMO-MRW），与青光眼模块高级版（GMPE）一起使用。GMPE 使用 BMO 提供了一种新的视神经头（ONH）分析的客观方法，但神经视网膜边缘评估是从 BMO 到 ILM 的最近点进行的，而不是在水平参考平面上进行的。这就是 BMO-MRW，它被定义为 ONH 中 BMO 和 ILM 之间的最小距离。
在这个视频中，从新手用户的角度解码 ONH 和 GMPE 的解剖结构，说明为什么 BMO-MRW 对于青光眼评估比传统的 BMO-HRW 更重要。
GMPE 概念以新颖的动态（临床与 OCT 与组织学）剧本形式呈现，通过 2D 和 3D 动画详细描述以下重点：ONH 的真实边缘、Bruch 膜（BM）、组织学与 OCT、BMO、Bruch 膜开口-最小边缘宽度、Bruch 膜开口-最小边缘宽度与 Bruch 膜开口-水平边缘宽度、ONH 的 Alpha、Beta、Gamma 区在 OCT 中、解剖定位系统、黄斑中心凹 BMO 中心轴的影响。
该视频还强调了，随着解剖定位系统的出现，每次随访时，扫描都能够相对于个体的黄斑中心凹至 BMO 中心（FoBMOC）轴进行对齐，以便准确检测到 BMO-MRW 中小于 1 微米的变化，从而在诊断青光眼和精确检测青光眼进展方面创造了一个新的世界。
