Retinal Nerve Fiber Layer Imaging with Spectral-Domain Optical Coherence Tomography A Study on Diagnostic Agreement with Heidelberg Retinal Tomograph
Retinal Nerve Fiber Layer Imaging with Spectral-Domain Optical Coherence Tomography A Study on Diagnostic Agreement with Heidelberg Retinal Tomograph
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DOI：
10.1016/j.ophtha.2009.06.061
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发表时间：
2010-02-01
期刊：
影响因子：
13.7
通讯作者：
Lam, Dennis Shun Chiu
中科院分区：
文献类型：
--
作者：
Leung, Christopher Kai-shun;Ye, Cong;Lam, Dennis Shun Chiu
目的：评价和比较共焦扫描激光检眼镜和光谱域光学相干断层扫描仪(OCT)在青光眼诊断中的一致性和检测性能。设计：前瞻性横断面研究。参与者：155名受试者(79名青光眼和76名正常受试者)。方法：分别从每名受试者中随机选择一只眼进行视盘和视网膜神经纤维层(RNFL)成像。根据Humphrey视野分析仪(Carl Zeiss Meditec，都柏林，CA)的视野缺陷的存在来定义青光眼。评估视盘的颞区、上鼻区、鼻上区、鼻下区和颞下区的分类(“在正常范围内”、“边界”和“在正常范围外”)的一致性(kappa统计)。比较视盘和RNFL诊断的敏感性和特异性(McNemar‘s统计法)。调整年龄、眼轴长度和视盘面积后，计算OCT RNFL和HRT视盘参数的受试者工作特征曲线下面积(AUC)。主要观察指标：分类的一致性、视盘的AUC和RNFL参数。结果：除整体(kappa=0.63)和颞下(kappa=0.68)测量外，HRT和SpectralisOCT的分类一致性为中到中等(kappa=0.30~0.53)。将青光眼定义为在全球和/或在<gt；=1的部门测量中具有“超出正常范围”的青光眼，Spectralis OCT和HRT在相似的特异度水平上的敏感度分别为91.1%和79.8%(P=0.012)(97.4%和94.7%)。OCT全层RNFL厚度AUC值(0.978)大于HRT全缘面积(0.905)、垂直杯盘比(0.857)、盘沿面积比(0.897)和多元判别分析(0.880~0.925)，均P
Objective: To evaluate and compare the diagnostic agreement and performance for glaucoma detection between a confocal scanning laser ophthalmoscope and a spectral-domain optical coherence tomograph (OCT).Design: Prospective, cross-sectional study.Participants: One hundred fifty-five subjects (79 glaucoma and 76 normal subjects).Methods: One eye from each individual was selected randomly for optic disc and retinal nerve fiber layer (RNFL) imaging by the Heidelberg Retinal Tomograph (HRT; Heidelberg Engineering, GmbH, Dossenheim, Germany) and the Spectralis OCT (Heidelberg Engineering), respectively. Glaucoma was defined based on the presence of visual field defects with the Humphrey visual field analyzer (Carl Zeiss Meditec, Dublin, CA). The agreement of the categorical classification ("within normal limits," " borderline," and "outside normal limits") at the temporal, superotemporal, superonasal, nasal, inferonasal and inferotemporal sectors of the optic disc were evaluated (kappa statistics). The diagnostic sensitivity and specificity between optic disc and RNFL assessment were compared (McNemar's statistics). Area under the receiver operating characteristic curve (AUC) of OCT RNFL and HRT optic disc parameters were computed after adjustment of age, axial length, and optic disc area.Main Outcome Measures: Agreement of categorical classification, AUC of optic disc, and RNFL parameters.Results: The agreement of categorical classification between HRT and Spectralis OCT were fair to moderate (kappa ranged between 0.30 and 0.53) except for global (kappa = 0.63) and inferotemporal (kappa = 0.68) measurements. Defining glaucoma as having " outside normal limits" in the global and/or in >= 1 of the sectoral measurements, the respective sensitivities of Spectralis OCT and HRT were 91.1% and 79.8% (P = 0.012) at a similar level of specificity (97.4% and 94.7%). The AUC of OCT global RNFL thickness (0.978) was greater than those of HRT global rim area (0.905), vertical cup-disc ratio (0.857), rim-disc area ratio (0.897), and multivariate discriminant analysis (0.880-0.925; all with P