Gonzalez-Hernandez Marta, Betancor-Caro Nisamar, Mesa-Lugo Fatima, Rodriguez-Talavera Ivan, Pareja-Rios Alicia, Guedes-Guedes Isabel, Estevez-Jorge Beatriz, Trujillo-Blanco Maricela, Cordova-Villegas Roberto, Espinoza-Gonzalez Juan, Siguero-Martin Leticia, Goya-Gonzalez Carolina, Rodriguez-Dominguez Maria, Gonzalez-Hernandez Daniel, Gonzalez de la Rosa Manuel
Instrumentacion y Oftalmologia, INSOFT S.L., 38004 Santa Cruz de Tenerife, Spain.
Hospital Universitario de Canarias, 38320 La Laguna, Spain.
J Clin Med. 2023 Sep 10;12(18):5876. doi: 10.3390/jcm12185876.
Previous retrospective results are evaluated prospectively and blinded.
A total of 221 eyes previously classified as normal (G1), 279 as moderate risk of glaucoma (G2) and 217 as high risk (G3) according to the Globin Discriminant Function (GDF) Laguna-ONhE index were examined with OCT Spectralis- Results: In G1, the Bruch's Membrane Opening Minimum Rim Width (BMO-MRW) was 332 ± 55 microns; in G2, it was 252 ± 47 ( < 0.0001); and in G3, 231 ± 44 ( < 0.0001). In G1, the 1% and 5% percentiles were 233 and 248, respectively; in G2, they were lower in 28.80% and 42.29% of cases, respectively; and in G3, in 50.23% and 63.59% of cases, respectively. Most of the cases were normal-tension glaucomas. Laguna-ONhE indices showed a curvilinear correlation with BMO-MRW results. The Retinal Nerve Fibre Layer (RNFL) showed a poor relationship with BMO. Assuming G1 to be truly normal, BMO-MRW would have a Receiver operating characteristic (ROC) curve area of 0.901 for G2 and G3 and 0.651 for RNFL. A significant reduction in pixels corresponding to vessels was found in G2 and G3 vs. G1 ( < 0.0001).
In some cases, these defects appear to be mainly glaucomatous, and in others, they are associated with diabetic microangiopathy. In normal tension glaucoma, RNFL defects may be less severe than those inside the nerve.
对既往回顾性研究结果进行前瞻性评估并采用盲法。
根据拉古纳-ONhE指数的血红蛋白判别功能（GDF），对先前分类为正常（G1）的221只眼、中度青光眼风险（G2）的279只眼和高风险（G3）的217只眼进行了光学相干断层扫描（OCT）光谱仪检查。结果：在G1组中，布鲁赫膜开口最小边缘宽度（BMO-MRW）为332±55微米；在G2组中，为252±47微米（<0.0001）；在G3组中，为231±44微米（<0.0001）。在G1组中，第1百分位数和第5百分位数分别为233和248；在G2组中，分别有28.80%和42.29%的病例低于这两个值；在G3组中，分别有50.23%和63.59%的病例低于这两个值。大多数病例为正常眼压性青光眼。拉古纳-ONhE指数与BMO-MRW结果呈曲线相关。视网膜神经纤维层（RNFL）与BMO的关系较差。假设G1组为真正正常，BMO-MRW对G2和G3组的受试者工作特征（ROC）曲线面积为0.901，对RNFL为0.651。与G1组相比，G2和G3组中与血管对应的像素显著减少（<0.0001）。
在某些情况下，这些缺陷似乎主要是青光眼性的，而在其他情况下，则与糖尿病微血管病变有关。在正常眼压性青光眼中，RNFL缺陷可能比神经内部的缺陷轻。
