Mahmoudinezhad Golnoush, Moghimi Sasan, Latif Kareem, Brye Nicole, Walker Evan, Nishida Takashi, Du Kelvin H, Gunasegaran Gopikasree, Wu Jo-Hsuan, Liebmann Jeffrey M, Fazio Massimo A, Girkin Christopher A, Zangwill Linda M, Weinreb Robert N
Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA.
Br J Ophthalmol. 2025 May 30;109(6):675-681. doi: 10.1136/bjo-2023-324916.
To evaluate the impact of testing frequency on the time required to detect statistically significant glaucoma progression for ganglion cell complex (GCC) with optical coherence tomography (OCT).
From multicentre glaucoma registries, 332 eyes of 201 glaucoma patients were enrolled over an average of 4.4 years. Patients with 4 or more OCT tests were selected to calculate the longitudinal rates of GCC thickness change over time by linear regression. A computer simulation was then used to generate real-world GCC data and assess the time required to detect progression at different loss rates and testing frequencies based on variability estimates. Time and accuracy to detect worsening of progression were calculated.
As testing frequency increased, the time required to detect a statistically significant negative GCC slope decreased, but not proportionally. All eyes with a GCC loss of -1 µm/year progressed after 3.8, 2.6 and 2.2 years on average when testing was conducted one, two and three times per year, respectively. For eyes with a GCC loss of -1.5 µm/year, progression was identified after 3.3, 2.2, and 1.8 years on average, respectively.
Increasing the frequency of macular OCT testing to three times per year more sensitively detects progression compared with two times per year. However, two times per year testing may be sufficient in clinical settings to detect progression and also to reduce the healthcare burden.
NCT00221897, NCT00221923.
评估检测频率对使用光学相干断层扫描（OCT）检测神经节细胞复合体（GCC）统计学上显著青光眼进展所需时间的影响。
从多中心青光眼登记处纳入201例青光眼患者的332只眼，平均随访4.4年。选择进行过4次或更多次OCT检测的患者，通过线性回归计算GCC厚度随时间的纵向变化率。然后使用计算机模拟生成真实世界的GCC数据，并根据变异性估计评估在不同损失率和检测频率下检测进展所需的时间。计算检测进展恶化的时间和准确性。
随着检测频率的增加，检测到统计学上显著的GCC负斜率所需的时间减少，但不是成比例减少。每年进行1次、2次和3次检测时，GCC每年损失-1μm的所有眼睛平均分别在3.8年、2.6年和2.2年后出现进展。对于GCC每年损失-1.5μm的眼睛，平均分别在3.3年、2.2年和1.8年后确定进展。
与每年检测2次相比，将黄斑OCT检测频率增加到每年3次能更灵敏地检测到进展。然而，在临床环境中，每年检测2次可能足以检测进展并减轻医疗负担。
NCT00221897，NCT00221923。
