多发性硬化症患者中Cirrus HD光学相干断层扫描视网膜层厚度测量的重测信度
Test-retest reliability of Cirrus HD-optical coherence tomography retinal layer thickness measurements in people with multiple sclerosis.
作者信息
Bacchetti Anna, McCormack Brenna, Lin Ting-Yi, Doosti Rozita, Ahmadi Gelareh, Ezzedin Omar, Pellegrini Nicole, Johnson Evan, Kim Anna, Otero-Duran Gabriel, Bonair Devon J, Lawrence Elle, Lievers Ernest, Davis Simidele, Park Sooyeon, Inserra Madeline, Gulati Ananya, Fitzgerald Kathryn C, Sotirchos Elias S, Calabresi Peter A, Saidha Shiv
机构信息
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
Mult Scler J Exp Transl Clin. 2025 May 11;11(2):20552173251340957. doi: 10.1177/20552173251340957. eCollection 2025 Apr-Jun.
BACKGROUND
Optical coherence tomography (OCT) allows evaluation of inter-eye differences (IEDs) in peri-papillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses to identify unilateral optic nerve involvement (UONI), which is included in the 2024 revised McDonald diagnostic criteria for multiple sclerosis (MS).
OBJECTIVES
To evaluate the test-retest reliability of pRNFL and GCIPL thicknesses/IEDs in people with MS, other neurological disorders, and healthy controls using Cirrus HD-OCT.
METHODS
509 participants underwent Cirrus HD-OCT, acquiring two macular and optic disc scans per eye within each session. Scans meeting OSCAR-IB quality control criteria were included in final analyses (959 eyes), with no clinical/demographic exclusions (reflecting a real-world clinical setting). Reliability was assessed using coefficients of variation (COVs), intraclass correlation coefficients (ICCs), and Bland-Altman limits of agreement (LOA). IED consistency was evaluated using difference-in-differences (DiDs) of test-retest measurements.
RESULTS
GCIPL demonstrated superior reliability (ICC: 0.998, COV: 0.40%, LOA: -1.29 to 1.35 μm) to pRNFL (ICC: 0.989, COV: 1.18%, LOA: -3.59 to 3.70 μm) thickness. Inter-eye absolute DiDs [pRNFL: 2.00 μm (standard deviation (SD) 1.73); GCIPL: 0.64 μm (SD 0.67)] were lower than IED thresholds proposed for identifying UONI.
CONCLUSIONS
The excellent reliability of GCIPL and pRNFL thicknesses/IEDs support OCT for identifying UONI to diagnose MS.
背景
光学相干断层扫描（OCT）可用于评估视乳头周围视网膜神经纤维层（pRNFL）和黄斑神经节细胞-内丛状层（GCIPL）厚度的双眼差异（IED），以识别单侧视神经受累（UONI），这一指标被纳入2024年修订的多发性硬化症（MS）麦克唐纳诊断标准中。
目的
使用Cirrus HD-OCT评估MS患者、其他神经系统疾病患者及健康对照者pRNFL和GCIPL厚度/IED的重测信度。
方法
509名参与者接受了Cirrus HD-OCT检查，每次检查时每只眼睛获取两次黄斑和视盘扫描图像。符合OSCAR-IB质量控制标准的扫描图像纳入最终分析（共959只眼），无临床/人口统计学排除标准（反映真实世界临床情况）。使用变异系数（COV）、组内相关系数（ICC）和布兰德-奥特曼一致性界限（LOA）评估信度。通过重测测量的差异中的差异（DiD）评估IED一致性。
结果
GCIPL厚度的信度（ICC：0.998，COV：0.40%，LOA：-1.29至1.35μm）优于pRNFL厚度（ICC：0.989，COV：1.18%，LOA：-3.59至3.70μm）。双眼绝对DiD [pRNFL：2.00μm（标准差（SD）1.73）；GCIPL：0.64μm（SD 0.67）]低于用于识别UONI的IED阈值。
结论
GCIPL和pRNFL厚度/IED的高信度支持使用OCT识别UONI以诊断MS。
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