Rationale and Development of an OCT-Based Method for Detection of Glaucomatous Optic Neuropathy.
Rationale and Development of an OCT-Based Method for Detection of Glaucomatous Optic Neuropathy.
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DOI：
10.1097/ijg.0000000000002005
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发表时间：
2022-06-01
影响因子：
2
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用于临床护理和研究的具体、敏感和主体间可验证的疾病定义仍然是青光眼领域未满足的重要需求。使用迭代、建立共识的方法并利用试点数据，寻求一种基于光学相干断层扫描 (OCT) 的方法来帮助检测青光眼视神经病变，以应对这一挑战。为了最大限度地提高成功机会，我们利用了 OCT 圆形和立方体扫描中的所有可用信息，应用定量和半定量数据分析方法，并旨在将视野检查的使用限制在绝对必要的情况下。该方法的结果是一种基于 OCT 的青光眼视神经病变诊断方法，不需要使用视野检查进行初步诊断。决策树是为临床实践和研究中的测试和实施而设计的，可供阅读中心、研究人员和临床医生使用。虽然最初的试点数据令人鼓舞，但仍需要未来的测试和验证来确定其在临床实践和研究中的效用。
A specific, sensitive and intersubjectively verifiable definition of disease for clinical care and research remains an important unmet need in the field of glaucoma. Using an iterative, consensus-building approach and employing pilot data, an optical coherence tomography (OCT)-based method to aid in the detection of glaucomatous optic neuropathy was sought to address this challenge. To maximize the chance of success, we utilized all available information from the OCT circle and cube scans, applied both quantitative and semi-quantitative data analysis methods, and aimed to limit the use of perimetry to cases where it is absolutely necessary. The outcome of this approach was an OCT-based method for diagnosis of glaucomatous optic neuropathy that did not require the use of perimetry for initial diagnosis. A decision-tree was devised for testing and implementation in clinical practice and research that can be used by reading centers, researchers, and clinicians. While intial pilot data were encouraging, future testing and validation will be needed to establish its utility in clinical practice, as well as for research.