Structure-Function Agreement Is Better Than Commonly Thought in Eyes With Early Glaucoma
Structure-Function Agreement Is Better Than Commonly Thought in Eyes With Early Glaucoma
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DOI：
10.1167/iovs.19-27920
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发表时间：
2019-10-01
影响因子：
4.4
通讯作者：
De Moraes, Carlos G.
中科院分区：
文献类型：
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作者：
Hood, Donald C.;Tsamis, Emmanouil;De Moraes, Carlos G.
目的.为了评估结构（光学相干断层扫描[OCT]）和功能（视野[VF]）之间的协议与自动化的方法和偏差/概率图，并比较这种方法的度量方法。从45只健康对照（H）眼/个体和53只24-2平均偏差（MD）优于-6 dB的专家诊断为“明确的青光眼”（DG）的患者中获得宽场谱域OCT扫描，包括椎间盘和黄斑，以及24-2和10-2 VF。根据VF模式偏差和OCT概率图，采用自动地形图（T）方法评估异常结构-异常功能（aS-aF）一致性。将结果与针对准确性优化的度量（M）方法进行比较（异常24-2青光眼半视野测试[GHT]或模式标准差[PSD]，或10-2 PSD和异常OCT [象限]）。对于T方法，53只DG眼中有47只（88.7%）显示aS-aF一致，而45只H眼中有2只（4.5%）显示aS-aF一致。这两只H眼的aS-aF一致性很容易被识别为错误的，并且在随后的测试中没有重复。在没有10-2的情况下，53只DG眼中的aS-aF一致性从47只下降到34只（64.2%）。对于M法，53只DG眼中有37只（69.8%）显示aS-aF一致，而省略10-2 VF仅导致33只（62.3%）一致。如果获得24-2和10-2 VF，并且将VF上的异常位置与OCT黄斑和椎间盘扫描上看到的异常区域进行比较，则即使在具有确认的早期青光眼损伤的眼睛中，结构和功能损伤之间也存在良好的一致性。这可以以客观、自动的方式完成。
PURPOSE. To assess the agreement between structural (optical coherence tomography [OCT]) and functional (visual field [VF]) glaucomatous damage with an automated method and deviation/probability maps, and to compare this method to a metric method.METHODS. Wide-field spectral-domain OCT scans, including the disc and macula, and 24-2 and 10-2 VFs were obtained from 45 healthy control (H) eyes/individuals, and 53 eyes/patients with 24-2 mean deviation (MD) better than -6 dB diagnosed as "definite glaucoma'' (DG) by experts. Abnormal structure-abnormal function (aS-aF) agreement was assessed with an automated topographic (T) method based upon VF pattern deviation and OCT probability maps. Results were compared to a metric (M) method optimized for accuracy, (abnormal 24-2 glaucoma hemifield test [GHT] or pattern standard deviation [PSD], or 10-2 PSD AND abnormal OCT [quadrant]).RESULTS. For the T-method, 47 (88.7%) of the 53 DG eyes showed aS-aF agreement, compared to 2 (4.5%) of the 45 H eyes. The aS-aF agreement for these two H eyes was easily identified as mistaken, and did not replicate on a subsequent test. Without the 10-2, the aS-aF agreement decreased from 47 to 34 (64.2%) of 53 DG eyes. For the M-method, 37 (69.8%) of the 53 DG eyes showed aS-aF agreement, while omitting the 10-2 VF resulted in agreement in only 33 (62.3%) eyes.CONCLUSIONS. There is good agreement between structural and functional damage, even in eyes with confirmed early glaucomatous damage, if both 24-2 and 10-2 VFs are obtained, and abnormal locations on the VFs are compared to abnormal regions seen on OCT macular and disc scans. This can be done in an objective, automated fashion.