Boussion François, Guindolet Damien, Deschamps Romain, Lamirel Cédric, Vignal-Clermont Catherine
Departmrnts of Ophthalmology.
Neurology, Hôpital Fondation Adolphe de Rothschild, rue Manin, Paris, France.
J Glaucoma. 2023 May 1;32(5):435-441. doi: 10.1097/IJG.0000000000002150. Epub 2023 Mar 13.
Global peripapillary retinal nerve fiber layer thickness (pRNFL)/Bruch membrane opening-minimum rim width (BMO-MRW) ratio is an objective and effective parameter to separate glaucomatous optic neuropathies (GONs) from nonGONs (NGONs).
This study was undertaken to evaluate the diagnostic capability of the pRNFL/ BMO-MRW ratio to differentiate GONs from NGONs.
This retrospective study included patients with an optic neuropathy (ON), visual loss for>6 months and a confirmed single etiology. pRNFL thickness and BMO-MRW were measured with spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The diagnostic accuracies of pRNFL, BMO-MRW and the global pRNFL/BMO-MRW ratio were evaluated with the areas under receiver operating characteristics curves.
One eye each from 171 patients was investigated: 50 primary open angle glaucomas, 15 normal pressure glaucomas, 50 optic neuritises, 15 nonarteritic anterior ischemic ONs, 24 compressive ONs, 10 dominant optic atrophies, and 7 nutritional ONs. The global pRNFL/BMO-MRW ratio had the highest area under receiver operating characteristics curve [0.97 vs. 0.92; P =0.01]. It was able to distinguish between GONs and NGONs with a cutoff value of 0.34. Increased mean deviation of the visual field-defect severity was associated with a higher ratio for GONs and a lower ratio for NGONs.
Compared with NGONs and for the same degree of pRNFL thinning, lower BMO- MRW was found to be a specific marker of glaucoma, reflecting the neuroglial architecture changes within the optic nerve head typical of glaucoma and supporting fundamental pathophysiological differences.
全球视乳头周围视网膜神经纤维层厚度（pRNFL）/布鲁赫膜开口最小边缘宽度（BMO-MRW）比值是区分青光眼性视神经病变（GONs）与非青光眼性视神经病变（NGONs）的客观有效参数。
本研究旨在评估pRNFL/BMO-MRW比值区分GONs与NGONs的诊断能力。
本回顾性研究纳入了患有视神经病变（ON）、视力丧失超过6个月且病因单一确诊的患者。使用光谱域光学相干断层扫描（德国海德堡海德堡工程公司的Spectralis）测量pRNFL厚度和BMO-MRW。通过受试者操作特征曲线下面积评估pRNFL、BMO-MRW和整体pRNFL/BMO-MRW比值的诊断准确性。
对171例患者的单眼进行了研究：50例原发性开角型青光眼、15例正常眼压性青光眼、50例视神经炎、15例非动脉炎性前部缺血性视神经病变（ON）、24例压迫性ON、10例显性视神经萎缩和7例营养性ON。整体pRNFL/BMO-MRW比值在受试者操作特征曲线下面积最高[0.97对0.92；P = 0.01]。它能够以0.34的临界值区分GONs与NGONs。视野缺损严重程度的平均偏差增加与GONs的较高比值和NGONs的较低比值相关。
与NGONs相比，在相同程度的pRNFL变薄情况下，较低的BMO-MRW被发现是青光眼的一个特异性标志物，反映了青光眼典型的视神经乳头内神经胶质结构变化，并支持基本的病理生理差异。
