Gowrisankaran Sowjanya, Abbasi Ashkan, Song Xubo, Schuman Joel S, Wollstein Gadi, Antony Bhavna J, Ishikawa Hiroshi
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.
Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA.
Transl Vis Sci Technol. 2025 May 1;14(5):13. doi: 10.1167/tvst.14.5.13.
Retinal nerve fiber layer thickness (RNFLT), a glaucoma biomarker, has a wide normative range affecting its sensitivity and specificity for abnormality detection. The interindividual RNFLT peak location variability contribution to this wide normative range has not been directly evaluated. The purpose of this study is to assess the effect of RNFLT peak normalization (PN) on normative variability.
Circumpapillary RNFLT profiles at 1.7 mm radius from the optic nerve head (ONH) were re-sampled from optical coherence tomography (OCT) volumes (Cirrus HD-OCT, 200 × 200) obtained from one eye of 83 healthy individuals. Fovea-ONH axis (FOA) was calculated from corresponding scanning laser ophthalmoscope images. Supratemporal (ST) and infratemporal (IT) RNFLT peaks of each profile were aligned to respective average peak locations. Normative ranges were calculated by averaging individual profiles before and after PN (with and without FOA to horizontal image axis (HA) alignment).
RNFLT-PN resulted in an overall decrease in coefficient of variation (CoV) of the normative range by 4.2% (P = 0.02). CoV was reduced by more than 10% in clock-hours 10 (11.9%), 8 (10.6%), 6 (10.4%) after PN, and 7 (16.3%), 10 (11.4%), and 12 (10.4%) after PN with FOA-HA alignment. RNFLT-PN corrected for abnormality categorization because of peak misalignment in RNFLT profiles of healthy and glaucoma suspect subjects.
RNFLT-PN reduces normative variability, especially in the ST and IT regions.
RNFLT-PN reduces normative variability and improves sectoral abnormality categorization, potentially leading to better sensitivity and specificity of RNFLT measure in glaucoma detection.
视网膜神经纤维层厚度（RNFLT）作为一种青光眼生物标志物，其正常范围较宽，这影响了其检测异常的敏感性和特异性。个体间RNFLT峰值位置变异性对这一较宽正常范围的影响尚未得到直接评估。本研究的目的是评估视网膜神经纤维层厚度峰值归一化（PN）对正常变异性的影响。
从83名健康个体一眼获取的光学相干断层扫描（OCT）容积（Cirrus HD - OCT，200×200）中重新采样距视神经乳头（ONH）半径1.7 mm处的视盘周围RNFLT轮廓。从相应的扫描激光检眼镜图像计算中央凹 - 视神经乳头轴（FOA）。将每个轮廓的颞上（ST）和颞下（IT）RNFLT峰值与各自的平均峰值位置对齐。通过对PN前后（有无FOA与水平图像轴（HA）对齐）的个体轮廓求平均值来计算正常范围。
RNFLT - PN导致正常范围的变异系数（CoV）总体降低4.2%（P = 0.02）。PN后，10点（11.9%）、8点（10.6%）、6点（10.4%）的CoV降低超过10%，FOA - HA对齐后，7点（16.3%）、10点（11.4%）和12点（10.4%）的CoV降低超过10%。RNFLT - PN纠正了因健康和疑似青光眼受试者RNFLT轮廓峰值未对齐导致的异常分类。
RNFLT - PN降低了正常变异性，尤其是在ST和IT区域。
RNFLT - PN降低了正常变异性，改善了扇形异常分类，可能导致RNFLT测量在青光眼检测中具有更好的敏感性和特异性。
