Zimmermann Caroline Maria, Cardakli Nur, Kraus Courtney Lynn
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, United States.
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Ophthalmol (Lausanne). 2024 Dec 3;4:1479286. doi: 10.3389/fopht.2024.1479286. eCollection 2024.
Compare cup-to-disc ratio (CDR) measured by clinical assessment and optical coherence tomography (OCT) in pediatric eyes being monitored as glaucoma suspects for suspicious optic disc appearance.
Retrospective cross-sectional study.
An institutional study following 221 eyes from 122 unique pediatric glaucoma suspects being monitored due to increased or asymmetric appearance of CDR. Ophthalmologic findings, including visual acuity, intraocular pressure, CDR measured by clinical assessment, average retinal nerve fiber layer thickness, and average CDR measured by OCT, were recorded for each participant's initial and final examinations. CDRs measured clinically and by OCT were compared at both initial and final presentations.
Average age at presentation was 9.0 years old (95% CI: 8.0-9.9), and mean length of follow-up was 5.0 years (95% CI: 5.4-4.5). At initial presentation, 53 eyes had CDRs recorded by both clinical assessment and OCT, and at final presentation, 93 eyes had CDRs measured by both modalities. CDR measured by OCT was significantly larger than CDR measured clinically on initial and final presentation (p=0.002, p<0.001).
Measurements of CDR by clinician assessment were significantly smaller than measurements obtained via OCT imaging. However, the average difference between CDR measured clinically and by OCT was <0.1. Thus, OCT may be a suitable way to measure CDR in pediatric glaucoma suspects, especially when clinical exam proves difficult. Further research is needed to assess CDR in glaucoma suspects using OCT longitudinally and in the context of other optic disc measurements, such as disc area.
比较临床评估和光学相干断层扫描（OCT）测量的杯盘比（CDR），这些测量是在因视盘外观可疑而被监测为青光眼疑似病例的儿童眼中进行的。
回顾性横断面研究。
一项机构性研究，对122名因CDR增大或不对称而被监测的独特儿童青光眼疑似病例的221只眼睛进行跟踪。记录了每位参与者初次和末次检查时的眼科检查结果，包括视力、眼压、临床评估测量的CDR、平均视网膜神经纤维层厚度以及OCT测量的平均CDR。在初次和末次就诊时，对临床测量的CDR和OCT测量的CDR进行了比较。
就诊时的平均年龄为9.0岁（95%可信区间：8.0 - 9.9），平均随访时间为5.0年（95%可信区间：5.4 - 4.5）。在初次就诊时，53只眼睛同时通过临床评估和OCT记录了CDR，在末次就诊时，93只眼睛通过两种方式测量了CDR。在初次和末次就诊时，OCT测量的CDR均显著大于临床测量的CDR（p = 0.002，p < 0.001）。
临床医生评估测量的CDR显著小于通过OCT成像获得的测量值。然而，临床测量的CDR与OCT测量的CDR之间的平均差异<0.1。因此，OCT可能是测量儿童青光眼疑似病例CDR的一种合适方法，尤其是在临床检查困难时。需要进一步研究，以纵向评估使用OCT测量青光眼疑似病例的CDR，并结合其他视盘测量指标，如视盘面积。
