Weinreb R N, Zangwill L, Berry C C, Bathija R, Sample P A
Glaucoma Center, University of California, San Diego, USA.
Arch Ophthalmol. 1998 Dec;116(12):1583-9. doi: 10.1001/archopht.116.12.1583.
To determine which retinal nerve fiber layer (RNFL) measures obtained with scanning laser polarimetry are most useful in detecting early to moderate glaucomatous visual field loss.
One eye from 84 healthy individuals and 83 patients with early to moderate glaucomatous visual field loss (167 eyes) was assessed with a scanning laser polarimeter (Laser Diagnostic Technologies, San Diego, Calif). Three separate scans were obtained, and a baseline scan was created and used in the analyses. Integrated software (program GDx, version 1.0.02; Laser Diagnostic Technologies) was evaluated by assessing its sensitivity and specificity for detecting early and moderate glaucomatous visual field loss. Fisher linear discriminant functions also were developed in this population to assess sensitivity and specificity and were compared with the GDx analyses.
There were statistically significant differences between the healthy and glaucomatous eyes for 14 of the 15 RNFL measures (P = .001). However, considerable overlap in measurements between groups was found. With the GDx number, the area under the receiver operator characteristic (ROC) curve was 0.78, and the sensitivity and specificity were 82% and 62%, respectively. Applying the best discriminant function using 3 variables (average thickness, ellipse modulation, and average ellipse thickness) to our study population resulted in an area under the ROC curve of 0.89 and a sensitivity and specificity of 74% and 92%, respectively.
A combination of RNFL measures obtained using the scanning laser polarimeter improved the ability to differentiate between healthy eyes and eyes with early and moderate glaucomatous visual field loss. Analyses using GDx software did not differentiate between healthy and glaucomatous eyes as well as the discriminant analysis function did.
确定扫描激光偏振仪所获得的哪些视网膜神经纤维层（RNFL）测量值最有助于检测早期至中度青光眼性视野缺损。
使用扫描激光偏振仪（激光诊断技术公司，加利福尼亚州圣地亚哥）对84名健康个体和83例早期至中度青光眼性视野缺损患者的一只眼睛（共167只眼）进行评估。进行了三次单独扫描，并创建了基线扫描用于分析。通过评估其检测早期和中度青光眼性视野缺损的敏感性和特异性，对集成软件（GDx程序，版本1.0.02；激光诊断技术公司）进行了评估。还在该人群中开发了费舍尔线性判别函数以评估敏感性和特异性，并与GDx分析结果进行比较。
15项RNFL测量值中的14项在健康眼和青光眼眼中存在统计学显著差异（P = .001）。然而，发现两组测量值有相当大的重叠。对于GDx数值，受试者操作特征（ROC）曲线下面积为0.78，敏感性和特异性分别为82%和62%。将使用3个变量（平均厚度、椭圆调制和平均椭圆厚度）的最佳判别函数应用于我们的研究人群，得到的ROC曲线下面积为0.89，敏感性和特异性分别为74%和92%。
使用扫描激光偏振仪获得的RNFL测量值组合提高了区分健康眼与早期和中度青光眼性视野缺损眼的能力。使用GDx软件的分析在区分健康眼和青光眼眼方面不如判别分析函数有效。
