Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY.
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
J Glaucoma. 2022 Nov 1;31(11):854-859. doi: 10.1097/IJG.0000000000002101. Epub 2022 Aug 11.
With high specificity and less variability than perimetry, more frequent testing resulted in shorter time to detect progression, though a 6-month testing interval provides a reasonable trade-off for following glaucoma patients using optical coherence tomography (OCT).
To investigate the time to detect progression in glaucomatous eyes using different OCT test intervals.
Participants with manifest glaucoma from the African Descent and Glaucoma Evaluation Study (ADAGES), a multicenter, prospective, observational cohort study, were included. A total of 2699 OCT tests from 171 glaucomatous and 149 normal eyes of 182 participants, with at least 5 tests and 2 years of follow-up, were analyzed. Computer simulations (n=10,000 eyes) were performed to estimate time to detect progression of global circumpapillary retinal nerve fiber layer thickness (cpRNFL) measured with OCT tests. Simulations were based on different testing paradigms (every 4, 6, 12, and 24 mo) and different rates of change (µm/year). Time to detect significant progression ( P <0.05) at 80% and 90% power were calculated for each paradigm and rate of cpRNFL change.
As expected, more frequent testing resulted in shorter time to detect progression. Although there was clear disadvantage for testing at intervals of 24 versus 12 months (22.4% time [25 mo] increase in time to progression detection) and when testing 12 versus 6 months (22.1% time [20 mo] increase), the improved time to detect progression was less pronounced when comparing 6 versus 4 months (~11.5% time [10 mo] reduction).
With high specificity and less variability than perimetry, a 6-month testing interval provides a reasonable trade-off for following glaucoma patients using OCT.
相较于视野检查，光学相干断层扫描（OCT）具有更高的特异性和更低的变异性，更频繁的检测可缩短发现进展的时间，但 6 个月的检测间隔为使用 OCT 监测青光眼患者提供了合理的权衡。
研究不同 OCT 检测间隔检测青光眼患者进展的时间。
纳入来自非洲裔美国人青光眼评估研究（ADAGES）的具有显性青光眼的参与者，ADAGES 是一项多中心、前瞻性、观察性队列研究。共分析了 182 名参与者的 171 只青光眼眼和 149 只正常眼的 2699 次 OCT 检查结果，这些参与者至少进行了 5 次检查，随访时间至少为 2 年。计算机模拟（n=10000 只眼）用于估计使用 OCT 检查测量的全周视盘视网膜神经纤维层厚度（cpRNFL）进展的检测时间。模拟基于不同的检测模式（每 4、6、12 和 24 个月）和不同的变化率（µm/年）。计算了每种模式和 cpRNFL 变化率的 80%和 90%效能下检测到显著进展的时间。
如预期的那样，更频繁的检测可缩短发现进展的时间。尽管与 12 个月相比，间隔 24 个月的检测（进展检测时间增加 22.4%[25 个月]）和 6 个月相比，12 个月的检测（进展检测时间增加 22.1%[20 个月]）具有明显的劣势，但与 4 个月相比，6 个月的检测（进展检测时间减少 11.5%[10 个月]）改善的进展检测时间并不明显。
相较于视野检查，OCT 具有更高的特异性和更低的变异性，6 个月的检测间隔为使用 OCT 监测青光眼患者提供了合理的权衡。
