Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Research & Development Div., Topcon Corporation, Tokyo, Japan.
Transl Vis Sci Technol. 2022 Jun 1;11(6):8. doi: 10.1167/tvst.11.6.8.
Retinal nerve fiber layer defects (RNFLDs) become enlarged with glaucoma progression. We measured the RNFLD angle and investigated whether it was correlated with deterioration of the visual field in patients with glaucoma.
This study included 84 eyes of 84 patients with open-angle glaucoma (mean deviation [MD] = -6.51 ± 5.91 dB, follow-up period = 2.82 ± 0.74 years) with the RNFLDs, who underwent en face swept-source optical coherence tomography (SS-OCT) wide scans (12 × 9 mm) at least 6 times. The RNFLD angle was measured as the intersection between the RNFLD and a circle centered on the disc with a radius half the distance between the disc and the fovea. Slopes for the RNFLD angle, macular ganglion cell layer thickness (GCCT), and circumpapillary RNFL thickness (cpRNFLT) were compared with the MD slope, as measured with the Humphrey field analyzer 24-2 program.
The correlation coefficients with MD slope were -0.67 for the RNFLD angle slope (P < 0.001), 0.15 for the macular GCCT slope (P = 0.163), and 0.04 for the cpRNFLT slope (P = 0.719). The RNFLD angle tended to increase as the number of disc hemorrhage occurrences increased (rs = 0.31, P = 0.004). The RNFLD angle slope also had good predictive power for glaucoma progression (area under the receiver operating characteristic curve = 0.88, 95% confidence interval = 0.81-0.95).
We found that the RNFLD angle slope was more closely associated with the MD slope than were other OCT parameters. This suggests that measurement of the RNFLD angle with en face OCT images could be effective in evaluating glaucoma progression.
Our study provides a method for monitoring glaucoma progression with SS-OCT.
随着青光眼的进展，视网膜神经纤维层缺损（RNFLD）会扩大。我们测量了 RNFLD 角度，并研究了其是否与青光眼患者视野恶化有关。
本研究纳入了 84 例（84 只眼）开角型青光眼患者，这些患者存在 RNFLD（平均偏差[MD]=-6.51±5.91dB，随访时间=2.82±0.74 年），并至少进行了 6 次基于 En Face 扫频源光学相干断层扫描（SS-OCT）的宽扫描（12×9mm）。通过以视盘为中心、以视盘和黄斑中心凹之间距离的一半为半径画一个圆，测量 RNFLD 与该圆的交点的角度，作为 RNFLD 角度。将 RNFLD 角度、黄斑神经节细胞层厚度（GCCT）和环周视网膜神经纤维层厚度（cpRNFLT）的斜率与 Humphrey 视野分析仪 24-2 程序测量的 MD 斜率进行比较。
RNFLD 角度斜率与 MD 斜率的相关系数为-0.67（P＜0.001），黄斑 GCCT 斜率为 0.15（P=0.163），cpRNFLT 斜率为 0.04（P=0.719）。随着视盘出血次数的增加，RNFLD 角度有增大的趋势（rs=0.31，P=0.004）。RNFLD 角度斜率对青光眼进展也有较好的预测能力（受试者工作特征曲线下面积=0.88，95%置信区间=0.81-0.95）。
我们发现，与其他 OCT 参数相比，RNFLD 角度斜率与 MD 斜率更为密切相关。这表明，使用 En Face OCT 图像测量 RNFLD 角度可能有助于评估青光眼的进展。
