基于光学相干断层扫描三维视盘边缘测量的事件分析与趋势分析在青光眼进展检测中的比较
Comparison of Event-based Analysis Versus Trend-based Analysis in the Detection of Glaucoma Progression by Optical Coherence Tomography 3-Dimensional Rim Measurements.
作者信息
Scott Tamara D, Guzman Aparicio Maria A, Ratanawongphaibul Kitiya, Lee Hang, Zemplenyi Michele, Tsikata Edem, Margeta Milica A, Ondeck Courtney L, Coleman Anne L, Yu Fei, de Boer Johannes F, Chen Teresa C
机构信息
Tufts University School of Medicine.
Harvard Medical School.
出版信息
J Glaucoma. 2025 Aug 1;34(8):616-624. doi: 10.1097/IJG.0000000000002573. Epub 2025 Apr 4.
PRCIS
Compared with trend-based analysis, event-based analysis detects OCT structural progression in more patients and at an earlier time point. Using event-based analysis, MDB rim thickness detects progression more often than RNFL thickness.
PURPOSE
To determine whether event-based or trend-based analysis best detects glaucoma progression using spectral domain optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and minimum distance band (MDB) neuroretinal rim measurements.
METHODS
Over 5 years, 124 open angle glaucoma patients had yearly dilated eye examinations, disc photography, Humphrey visual field (HVF 24-2) testing, 2-dimensional (2D) OCT RNFL thickness measurements, and 3-dimensional (3D) OCT MDB rim measurements, all on the same day. One eye of each patient was analyzed, which was randomly selected if both eyes from a patient were eligible. Using global RNFL thickness and global MDB rim thickness, event-based progression was defined as change greater than normal aging change and expected inter-test variability. Trend-based analysis used linear regression with progression defined as rate of decline greater than age-related decline.
RESULTS
The average follow-up for the 124 open angle glaucoma patients was 66.9±16.4 months. Event-based analysis was better than trend-based analysis because it detected progression in more patients (15.3% by RNFL event-based analysis versus 8.1% by RNFL trend-based analysis, P =0.025; 52.4% by MDB event-based analysis versus 9.7% by MDB trend-based analysis, P <0.001) and earlier (RNFL: mean 28.8 vs. 63.2 mo; P <0.001; MDB: mean 30.7 vs. 56.2 mo; P <0.003) whether using MDB rim thickness or RNFL thickness. Using event-based analysis, MDB rim thickness detected progression more often than RNFL thickness (52.4% vs. 15.3%; P <0.001).
CONCLUSIONS
Compared with trend-based analysis, event-based analysis detected OCT structural progression in more glaucoma patients and at an earlier time point.
PRCIS
与基于趋势的分析相比，基于事件的分析能在更多患者中更早地检测到光学相干断层扫描（OCT）结构进展。使用基于事件的分析，最小距离带（MDB）边缘厚度比视网膜神经纤维层（RNFL）厚度更常检测到进展。
目的
使用光谱域光学相干断层扫描（OCT）测量视网膜神经纤维层（RNFL）厚度和最小距离带（MDB）神经视网膜边缘，以确定基于事件的分析还是基于趋势的分析最能检测青光眼进展。
方法
在5年时间里，124例开角型青光眼患者在同一天进行年度散瞳眼部检查、视盘照相、Humphrey视野（HVF 24-2）测试、二维（2D）OCT测量RNFL厚度以及三维（3D）OCT测量MDB边缘厚度。如果患者的双眼均符合条件，则随机选择一只眼睛进行分析。使用总体RNFL厚度和总体MDB边缘厚度，基于事件的进展定义为变化大于正常衰老变化和预期的测试间变异性。基于趋势 的分析使用线性回归，进展定义为下降速率大于与年龄相关的下降速率。
结果
124例开角型青光眼患者的平均随访时间为66.9±16.4个月。基于事件的分析优于基于趋势的分析，因为它能在更多患者中检测到进展（基于RNFL事件的分析为15.3%，基于RNFL趋势的分析为8.1%，P =0.025；基于MDB事件的分析为52.4%，基于MDB趋势的分析为9.7%，P<0.001）且更早（RNFL：平均28.8个月对63.2个月；P<0.001；MDB：平均30.7个月对56.2个月；P<0.003），无论使用MDB边缘厚度还是RNFL厚度。使用基于事件的分析，MDB边缘厚度比RNFL厚度更常检测到进展（52.4%对15.3%；P<0.001）。
结论
与基于趋势的分析相比，基于事件的分析能在更多青光眼患者中更早地检测到OCT结构进展。
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