盘沿地形测量值对青光眼疑似病例与早期原发性开角型青光眼病例的鉴别价值：一条细微的鉴别线。

Value of disc topographic measurements for the discrimination of glaucoma suspects from early primary open angle glaucoma cases: A thin discriminative line.

机构信息

Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul 34668, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2023 Sep;43:103746. doi: 10.1016/j.pdpdt.2023.103746. Epub 2023 Aug 17.

DOI:10.1016/j.pdpdt.2023.103746

PMID:37595654

Abstract

PURPOSE

To determine the diagnostic value of optic nerve head (ONH) topographic parameters measured by swept-source optical coherence tomography (SS-OCT) in differentiating between early glaucoma cases, glaucoma suspects (GSs), and healthy eyes.

METHODS

The files of GSs, those with an early primary open angle glaucoma (POAG) diagnosis, and healthy eyes were retrospectively screened. Demographic characteristics, retinal nerve fibre measurements, visual field examinations, and ONH topographic parameters, including rim area, disc area, vertical and horizontal cup-to-disc ratios (CDRs), and cup volume, were compared between the groups. A receiver operating characteristic (ROC) curve analysis was performed on the ONH parameters.

RESULTS

A total of 170 eyes from 85 GSs, 114 eyes from 57 patients with a diagnosis of early POAG, and 70 healthy eyes from 48 subjects were included in the study. The median age was 52.1 ± 0.9 years for the POAG group, 60.2 ± 1.1 years for the GS group, and 60.5 ± 1.6 for the controls. In the comparison of the ONH parameters between the groups, only rim area statistically significantly differed between the POAG and GS groups. However, all ONH parameters statistically significantly differed between the GS and control groups (p< 0.05). The mean rim areas of the GS, POAG, and control groups were 1.278 ± 0.055 mm, 1.073 ± 0.065 mm, and 1.446 ± 0.055 mm, respectively, being statistically significantly higher in the controls and lower in the POAG group (p < 0.001). The highest area under the curve (AUC) value belonged to vertical CDR for the discrimination of the eyes with POAG from healthy eyes [0.806 (0.728-0.869, p < 0.001] and rim area for the discrimination of POAG cases and GSs [0.728 (0.650-0.797, p < 0.001].

CONCLUSION

There are significant differences in all ONH parameters between the eyes of GSs and healthy eyes. For the discrimination of early POAG and GS cases, topographic disc parameters may have value. In this study, rim area significantly differed between the GS and POAG groups, and it had the highest AUC value amongst the evaluated ONH parameters in the discrimination of early POAG cases S GSs.

摘要

目的

通过扫频源光学相干断层扫描（SS-OCT）测量视盘顶（ONH）参数，确定其在鉴别早期青光眼病例、青光眼疑似病例（GSs）和健康眼中的诊断价值。

方法

回顾性筛选 GSs、早期原发性开角型青光眼（POAG）诊断患者和健康眼的文件。比较各组之间的人口统计学特征、视网膜神经纤维测量值、视野检查和 ONH 顶（ONH）参数，包括边缘面积、盘面积、垂直和水平杯盘比（CDR）和杯容积。对 ONH 参数进行受试者工作特征（ROC）曲线分析。

结果

研究纳入了 85 例 GSs 中的 170 只眼、57 例早期 POAG 患者中的 114 只眼和 48 例健康眼中的 70 只眼。POAG 组的中位年龄为 52.1±0.9 岁，GS 组为 60.2±1.1 岁，对照组为 60.5±1.6 岁。在各组之间的 ONH 参数比较中，仅边缘面积在 POAG 组和 GS 组之间存在统计学差异。然而，所有 ONH 参数在 GS 组和对照组之间均有统计学差异（p<0.05）。GS、POAG 和对照组的平均边缘面积分别为 1.278±0.055mm、1.073±0.065mm 和 1.446±0.055mm，对照组明显更高，POAG 组明显更低（p<0.001）。用于鉴别 POAG 眼与健康眼的最佳曲线下面积（AUC）值属于垂直 CDR（0.806[0.728-0.869，p<0.001]），用于鉴别 POAG 病例和 GSs 的最佳 AUC 值属于边缘面积（0.728[0.650-0.797，p<0.001]）。