视盘光学相干断层扫描标准数据库在一个大型、多样化的真实世界队列中的表现
Performance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort.
作者信息
Ramachandran Rithambara, Lu Ming-Chen, Niziol Leslie M, Woodward Maria A, Elam Angela R, Johnson Leroy, Kershaw Martha, Musch David C, Bicket Amanda, John Denise, Dougherty Wood Sarah, Zhang Amy, Zhang Jason, O'Brien Joan, Newman-Casey Paula Anne
机构信息
Departments of Ophthalmology and Visual Sciences.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.
出版信息
J Glaucoma. 2025 May 1;34(5):404-414. doi: 10.1097/IJG.0000000000002545. Epub 2025 Jan 30.
PRCIS
Current optical coherence tomography normative sample data may not represent the diversity of human optic nerve anatomy needed to accurately classify all individuals with true glaucomatous optic neuropathy.
PURPOSE
To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a larger, more diverse cohort of healthy individuals.
PATIENTS AND METHODS
ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared. χ 2 tests compared MI-SIGHT retinal nerve fiber layer (RNFL) quadrant color-code labels with the expected distribution and multinomial logistic regression identified factors associated with label classifications.
RESULTS
In all, 1084 MI-SIGHT and 399 Topcon eyes were evaluated. The MI-SIGHT cohort was older (54 vs. 46 y), with more individuals identifying as black (61% vs. 20%), fewer as Hispanic (4% vs. 18%), and spherical equivalents closer to plano (-0.6 vs. -1.2 diopters) compared to the Topcon cohort (all P <0.001). Black/African American MI-SIGHT participants had larger cup-to-disc ratios and cup volumes, while white MI-SIGHT participants had smaller ONH values, except for rim area and rim volume, compared to Topcon participants (all P <0.001). The MI-SIGHT cohort's RNFL color codes did not follow the expected distribution ( P <0.05); more MI-SIGHT RNFL quadrant measurements were assigned as white (10.6% and 6.3% MI-SIGHT vs. 5% Topcon) and red codes (2.2% and 1.8% MI-SIGHT vs. <1% Topcon) than expected in the superior and inferior quadrants, respectively.
CONCLUSIONS
OCT normative databases should accurately reflect diverse populations to avoid misclassification by RNFL thickness color codes. Larger data sets should be leveraged to encompass the full spectrum of healthy optic nerve anatomy.
目的
比较光学相干断层扫描（OCT）标准数据库公布的值与更大、更多样化的健康个体队列之间的视神经乳头（ONH）测量值。
患者和方法
比较了密歇根州通过远程医疗进行青光眼和眼部健康筛查与干预（MI-SIGHT）项目的健康参与者和拓普康Maestro-1标准队列的ONH参数。χ²检验比较了MI-SIGHT视网膜神经纤维层（RNFL）象限颜色编码标签与预期分布，多项逻辑回归确定了与标签分类相关的因素。
结果
总共评估了1084只MI-SIGHT眼睛和399只拓普康眼睛。与拓普康队列相比，MI-SIGHT队列年龄更大（54岁对46岁），更多个体为黑人（61%对20%），西班牙裔更少（4%对18%），等效球镜更接近平光（-0.6对-1.2屈光度）（所有P<0.001）。与拓普康参与者相比，黑人/非裔美国MI-SIGHT参与者的杯盘比和杯容积更大，而白人MI-SIGHT参与者的ONH值更小，但边缘面积和边缘容积除外（所有P<0.001）。MI-SIGHT队列的RNFL颜色编码不符合预期分布（P<0.05）；与预期相比，MI-SIGHT的RNFL象限测量值在上方和下方象限分别被指定为白色（MI-SIGHT为10.6%和6.3%，拓普康为5%）和红色编码（MI-SIGHT为2.2%和1.8%，拓普康<1%）的更多。
结论
OCT标准数据库应准确反映不同人群，以避免因RNFL厚度颜色编码导致的错误分类。应利用更大的数据集来涵盖健康视神经解剖结构的全谱。
中华医学会眼科学分会国际视网膜学会（PRCIS）：当前的光学相干断层扫描标准样本数据可能无法代表准确分类所有真正青光眼性视神经病变个体所需的人类视神经解剖结构的多样性。
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