Comparison of the Diagnostic Accuracies of the Spectralis, Cirrus, and RTVue Optical Coherence Tomography Devices in Glaucoma
Comparison of the Diagnostic Accuracies of the Spectralis, Cirrus, and RTVue Optical Coherence Tomography Devices in Glaucoma
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DOI：
10.1016/j.ophtha.2010.11.029
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发表时间：
2011-07-01
期刊：
影响因子：
13.7
通讯作者：
Medeiros, Felipe A.
中科院分区：
文献类型：
--
作者：
Leite, Mauro T.;Rao, Harsha L.;Medeiros, Felipe A.
目的：比较Spectralis （Heidelberg Engineering, dosenheim, Germany）、Cirrus （Carl Zeiss Meditec, Dublin， CA）和RTVue （Optovue Inc., Fremont， CA）设备对青光眼的诊断准确性。设计：诊断性病例对照研究。参与者：来自青光眼纵向诊断创新研究（DIGS）和非洲裔青光眼评估研究（ADAGES）的149名参与者中，共有233人（107人健康，126人青光眼）。方法：所有参与者在同一次访问中使用Spectralis， Cirrus和RTVue设备进行RNFL厚度成像。获得所有仪器的象限（上、鼻、下、颞）和整体RNFL厚度的年龄和种族调整后的受试者工作特征（ROC）曲线。计算并比较固定特异性（80%和95%）的ROC下面积（AUC）和灵敏度。主要结局指标：比较使用auc的诊断准确性和固定特异性为80%和95%的敏感性。结果：auc最大的RNFL厚度参数为Spectralis的上象限（0.88），卷云的整体RNFL厚度（0.88）和RTVue（0.87）。ROC曲线两两比较显示，除鼻象限外，所有参数均无统计学差异，Spectralis和RTVue的AUC均明显大于卷云（P < 0.03）。各仪器最佳参数的敏感性差异无统计学意义（P < 0.05）。Spectralis测量的上象限厚度灵敏度为81.9%，固定特异性为80%，固定特异性为95%，灵敏度为70%。卷云测量的整体厚度在80%的固定特异性下敏感性为80.3%，在95%的固定特异性下敏感性为65.6%。对于RTVue，在80%的固定特异性下，总厚度的敏感性为77.9%，在95%的固定特异性下，敏感性为62.1%。结论：虽然光谱域光学相干断层扫描（SD-OCT）仪器的分辨率和采集率不同，但它们检测青光眼的能力是相似的。
Purpose: To compare the diagnostic accuracies of retinal nerve fiber layer (RNFL) thickness measurements obtained with the Spectralis (Heidelberg Engineering, Dossenheim, Germany), Cirrus (Carl Zeiss Meditec, Dublin, CA), and RTVue (Optovue Inc., Fremont, CA) devices for the detection of glaucoma.Design: Diagnostic, case-control study.Participants: A total of 233 (107 healthy, 126 glaucomatous) of 149 participants from the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS) and from the African Descent and Glaucoma Evaluation Study (ADAGES).Methods: All participants underwent RNFL thickness imaging with the Spectralis, Cirrus, and RTVue devices in the same visit. Receiver operating characteristic (ROC) curves adjusted for age and race were obtained for quadrants (superior, nasal, inferior, temporal) and global RNFL thickness for all instruments. Areas under ROC (AUC) and sensitivities at fixed specificities (80% and 95%) were calculated and compared.Main Outcome Measures: Comparison of diagnostic accuracy using AUCs and sensitivities at fixed specificities of 80% and 95%.Results: The RNFL thickness parameter with the largest AUCs was the superior quadrant for the Spectralis (0.88) and the global RNFL thickness for the Cirrus (0.88) and the RTVue (0.87). The pairwise comparison among the ROC curves showed no statistical difference for all parameters except for the nasal quadrant, which had significantly larger AUC in the Spectralis and RTVue compared with the Cirrus (P < 0.03 for both comparisons). There were no significant differences in sensitivities among the best parameters from each instrument (P > 0.05). The superior quadrant thickness measured with the Spectralis had sensitivity of 81.9% at a fixed specificity of 80% and 70% at a fixed specificity of 95%. The global thickness measured by the Cirrus had a sensitivity of 80.3% at a fixed specificity of 80% and 65.6% at a fixed specificity of 95%. For the RTVue, the global thickness had a sensitivity of 77.9% at a fixed specificity of 80% and 62.1% at a fixed specificity of 95%.Conclusions: Although the spectral-domain optic coherence tomography (SD-OCT) instruments have different resolution and acquisition rates, their ability to detect glaucoma was similar.