Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Topcon Corporation, Tokyo, Japan.
Transl Vis Sci Technol. 2022 Oct 3;11(10):11. doi: 10.1167/tvst.11.10.11.
The purpose of this study was to evaluate the diagnostic performance of retinal blood flow (RBF) measured with the Doppler optical coherence tomography (OCT) segmental scanning method to distinguish between healthy and glaucoma eyes.
Fifty-eight patients with normal tension glaucoma (NTG) who had a single-hemifield visual field defect and 44 age-matched healthy subjects were enrolled. Retinal nerve fiber layer thickness (RNFLT) was measured with swept-source OCT. Superior and inferior temporal arteries (TAs) and temporal veins (TVs) RBF were measured with Doppler OCT. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to compare the diagnostic performances in the damaged and normal hemispheres.
Multivariate regression analysis showed TA RBF and TV RBF were significantly reduced in the damaged and normal hemispheres. The ROC analysis showed that the AUC for quadrant RNFLT, TA RBF, and TV RBF were 0.973, 0.909, and 0.872 in the damaged hemisphere, respectively. The AUC values in the normal hemisphere were 0.783, 0.744, and 0.697, respectively. The combination of quadrant RNFLT and TA/TV RBF had a greater AUC than quadrant RNFLT alone in both damaged (AUC = 0.987) and normal (AUC = 0.825) hemispheres.
In NTG eyes with single-hemifield damage, the RBF was found to be significantly reduced in the damaged and normal hemispheres independent from structural changes. The combination of RNFLT and RBF could improve diagnostic performances for glaucoma.
Combining morphological and blood flow measurements with Doppler OCT may be useful in glaucoma diagnosis.
本研究旨在评估使用多普勒光相干断层扫描（OCT）分段扫描法测量视网膜血流（RBF）来区分健康眼和青光眼眼的诊断性能。
纳入 58 例单侧视野缺损的正常眼压性青光眼（NTG）患者和 44 例年龄匹配的健康对照者。采用扫频源 OCT 测量视网膜神经纤维层厚度（RNFLT）。使用多普勒 OCT 测量颞上动脉（TA）和颞静脉（TV）的 RBF。采用受试者工作特征（ROC）曲线下面积（AUC）比较损伤半球和正常半球的诊断性能。
多元回归分析显示，损伤半球和正常半球的 TA RBF 和 TV RBF 均显著降低。ROC 分析显示，象限 RNFLT、TA RBF 和 TV RBF 在损伤半球的 AUC 分别为 0.973、0.909 和 0.872，在正常半球的 AUC 分别为 0.783、0.744 和 0.697。象限 RNFLT 与 TA/TV RBF 联合检测的 AUC 在损伤半球（AUC=0.987）和正常半球（AUC=0.825）均大于象限 RNFLT 单独检测。
在单侧视野损伤的 NTG 眼中，损伤半球和正常半球的 RBF 均显著降低，与结构变化无关。将 RNFLT 和 RBF 相结合可以提高青光眼的诊断性能。
庄立强
