Palmer Laura D, Thompson Atalie C, Asrani Sanjay
Wake Forest University School of Medicine.
Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem.
Curr Opin Ophthalmol. 2025 Mar 1;36(2):130-134. doi: 10.1097/ICU.0000000000001106. Epub 2024 Nov 7.
Optical coherence tomography (OCT) is a widely used tool to diagnose and monitor glaucoma by objectively measuring the ganglion cell layer and the retinal nerve fiber layer (RNFL) thickness. The presence of RNFL thinning raises suspicion for glaucoma progression. Therefore, this review aims to discuss current approaches to using OCT for detecting glaucomatous change, limitations, and recent advancements.
Previously established approaches to determining glaucomatous progression on OCT include quantitative and qualitative methods. The most common quantitative methods include event-based and trend-based analysis. Decreasing RNFL thickness or loss of the ganglion cell layer are indicative of glaucomatous changes. However, interpretation of OCT scans is strongly impacted by artifacts, which can be because of epiretinal membrane or posterior vitreous detachment. Race and aging also may impact interpretation of RNFL progression. More recent research focuses on loss of the RNFL because of the effects of systemic conditions. Given the limitations in the current approaches, recent advancements indicate a promising role for artificial intelligence in determining true glaucomatous progression.
This review highlights current approaches to identifying glaucoma progression on OCT, limitations to these approaches, and the potential role for artificial intelligence.
光学相干断层扫描（OCT）是一种通过客观测量神经节细胞层和视网膜神经纤维层（RNFL）厚度来诊断和监测青光眼的广泛应用工具。RNFL变薄提示青光眼进展。因此，本综述旨在探讨当前使用OCT检测青光眼性改变的方法、局限性及最新进展。
先前确立的在OCT上确定青光眼进展的方法包括定量和定性方法。最常见的定量方法包括基于事件和基于趋势的分析。RNFL厚度减小或神经节细胞层缺失提示青光眼性改变。然而，OCT扫描的解读受伪像的强烈影响，伪像可能由视网膜前膜或玻璃体后脱离引起。种族和年龄也可能影响RNFL进展的解读。最近的研究聚焦于全身状况影响导致的RNFL缺失。鉴于当前方法存在局限性，最新进展表明人工智能在确定真正的青光眼进展方面具有广阔前景。
本综述强调了当前在OCT上识别青光眼进展的方法、这些方法的局限性以及人工智能的潜在作用。
