Longitudinal Variability of Optic Disc and Retinal Nerve Fiber Layer Measurements
Longitudinal Variability of Optic Disc and Retinal Nerve Fiber Layer Measurements
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DOI：
10.1167/iovs.07-1187
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发表时间：
2008-11-01
影响因子：
4.4
通讯作者：
Weinreb, Robert N.
中科院分区：
文献类型：
--
作者：
Leung, Christopher Kai-shun;Cheung, Carol Yim-lui;Weinreb, Robert N.
目的。为了评价光学相干断层扫描(OCT)、扫描激光偏振仪(SLP)和激光共聚焦扫描眼底镜(CSLO)测量视盘和视网膜神经纤维层(RNFL)的纵向变异性。方法对88例(45只正常眼)和43只青光眼(青光眼)进行纵向研究。用OCT(StatusOCT；Carl Zeiss Meditec，都柏林，CA)和SLP(GDX VCC；Carl Zeiss Meditec)测量RNFL厚度。用CSLO(HRT3；Heidelberg Engineering，GmbH，Dossenheim，德国)测量神经视网膜边缘面积。在平均8.8+/-1.2个月的时间内进行了三次单独的测量，以评估测量的可变性。计算重复性系数、变异系数、组内相关系数(ICC)和变化敏感度[(97.5百分位值-2.5百分位值)/2中心点受试者内标准差(Sw)]。用回归分析评价RNFL和RNFL测量变异性与视野MD(平均偏差)的关系。结果：全球和分区测量的RNFL和RNFL的变异性较低。OCT平均RNFL厚度、GDX VCC TSNIT平均值和HRT全球边缘面积的重复性系数、ICC和变化敏感度分别为11.7微米(95%可信区间：10.5~12.9微米)、0.97(0.96~0.98)、10.2(9.2~11.4)微米、4.7微米(4.2~5.1微米)、0.98(0.97~0.99)、11.3(10.2~12.6)；0.22 mm(2)(0.19~0.24 mm(2))、0.97(0.95~0.98)、9.3(8.4~10.4)mm。OCT(r=0.010[95%CI：-0.200~0.219]，P=0.924)与SLP(r=-0.034[95%CI：-0.241~0.177]，P=0.756)无相关性。调整参考高度变量后，CSLO边缘面积变异与视野MD之间的相关性变得不显著。结论：OCT、SLP和CSLO获得的纵向RNFL和神经视网膜边缘测量具有较低的变异性。由于测量变异性不随青光眼的严重程度改变，这些参数对青光眼进展的评估是有用的。(投资眼科VS科学。2008年；49：4886-4892)doi：10.1167/iovs.07-1187
PURPOSE. To evaluate the longitudinal variability of optic disc and retinal nerve fiber layer (RNFL) measurements obtained from optical coherence tomography (OCT), scanning laser polarimetry (SLP), and confocal scanning laser ophthalmoscopy (CSLO).METHODS. Forty-five normal and 43 glaucomatous eyes of 88 subjects were analyzed in this longitudinal study. RNFL thickness was measured by OCT (StatusOCT; Carl Zeiss Meditec, Dublin, CA) and SLP (GDx VCC; Carl Zeiss Meditec). Neuro-retinal rim area was measured by CSLO (HRT 3; Heidelberg Engineering, GmbH, Dossenheim, Germany). Three separate measurements taken over an average period of 8.8 +/- 1.2 months were used to evaluate measurement variability. Reproducibility coefficient, coefficient of variation, intraclass correlation coefficient (ICC), and sensitivity to change [(97.5 percentile value - 2.5 percentile value)/2 center dot within-subject standard deviation (Sw)] of the global measures were calculated. The association between RNFL and rim area measurement variability and visual field MD ( mean deviation) was evaluated with regression analysis.RESULTS. Low variability was found for global and sectorial rim area and RNFL measurements. The reproducibility coefficient, ICC, and sensitivity to change for OCT average RNFL thickness, GDx VCC TSNIT average, and HRT global rim area were 11.7 mu m (95% confidence interval [CI]: 10.5-12.9 mu m), 0.97 (0.96-0.98), 10.2(9.2-11.4); 4.7 mu m (4.2-5.1 mu m), 0.98 (0.97-0.99), 11.3 (10.2-12.6); and 0.22 mm(2) (0.19-0.24 mm(2)), 0.97 (0.95-0.98), 9.3 (8.4-10.4), respectively. No association was found between OCT (r = 0.010 [95% CI: -0.200-0.219], P = 0.924) and SLP (r = -0.034 [95% CI: -0.241-0.177], P = 0.756) RNFL thickness variances and visual field MD. The association between CSLO rim area variance and visual field MD became insignificant after adjustment for reference height variance.CONCLUSIONS. Longitudinal RNFL and neuroretinal rim measurements obtained with OCT, SLP, and CSLO have low variability. As the measurement variability does not change with the severity of glaucoma, these parameters are useful for assessment of glaucoma progression. (Invest Ophthalmol Vis Sci. 2008;49: 4886-4892) DOI:10.1167/iovs.07-1187