Evaluation of the Structure-Function Relationship in Glaucoma Using a Novel Method for Estimating the Number of Retinal Ganglion Cells in the Human Retina
Evaluation of the Structure-Function Relationship in Glaucoma Using a Novel Method for Estimating the Number of Retinal Ganglion Cells in the Human Retina
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DOI：
10.1167/iovs.14-16366
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发表时间：
2015-08-01
影响因子：
4.4
通讯作者：
Hood, Donald C.
中科院分区：
文献类型：
--
作者：
Raza, Ali S.;Hood, Donald C.
目的。我们开发了一种使用光学相干断层扫描（OCT）估计人类视网膜视网膜神经节细胞（RGCs）数量的简单方法，并将其与之前的方法进行了比较，并证明了其进一步理解青光眼结构-功能关系的潜力。获得36例健康对照者43只眼、50例青光眼患者和疑似青光眼患者50只眼的扫描源OCT数据和10-2视野（VFs）。利用文献中对RGC密度的估计和相对较少的假设，基于ssoct衍生的RGC层厚度测量获得了黄斑中RGC数量的估计。RGC估计值与先前公布的组织学值基本一致，而先前基于VF敏感性的方法与组织学数据不太一致，并且与基于ssOCT的新方法相比，RGC估计值显着更高（P = 0.001）和更多变量（P < 0.001）。然而，对于极端的VF损失，RGC对新方法的估计并非为零，这表明需要添加剩余的非RGC贡献。最后，新的ssoct衍生的RGC估计与VF敏感性显著相关（P < 0.001至P = 0.018） （Spearman’s q = 0.26-0.47），并且，与先前研究的结论相反，统计学上显著的RGC丧失并不比统计学上显著的视力丧失发生的频率更高。这种估算rgc的新方法产生的值比以前的方法更接近组织学估计值，同时所依赖的假设要少得多。虽然临床应用的附加价值尚未确定，但该方法对于评估青光眼的结构-功能关系是有用的。
PURPOSE. We developed a simple method for estimating the number of retinal ganglion cells (RGCs) in the human retina using optical coherence tomography (OCT), compared it to a previous approach, and demonstrated its potential for furthering our understanding of the structure-function relationship in glaucoma.METHODS. Swept-source (ss) OCT data and 10-2 visual fields (VFs) were obtained from 43 eyes of 36 healthy controls, and 50 eyes of 50 glaucoma patients and suspects. Using estimates of RGC density from the literature and relatively few assumptions, estimates of the number of RGCs in the macula were obtained based on ssOCT-derived RGC layer thickness measurements.RESULTS. The RGC estimates were in general agreement with previously published values derived from histology, whereas a prior method based on VF sensitivity did not agree as well with histological data and had significantly higher (P = 0.001) and more variable (P < 0.001) RGC estimates than the new method based on ssOCT. However, the RGC estimates of the new approach were not zero for extreme VF losses, suggesting that a residual, non-RGC contribution needs to be added. Finally, the new ssOCT-derived RGC estimates were significantly (P < 0.001 to P = 0.018) related to VF sensitivity (Spearman's q = 0.26-0.47), and, in contrast to claims made in prior studies, statistically significant RGC loss did not occur more often than statistically significant visual loss.CONCLUSIONS. The novel method for estimating RGCs yields values that are closer to histological estimates than prior methods, while relying on considerably fewer assumptions. Although the value added for clinical applications is yet to be determined, this approach is useful for assessing the structure-function relationship in glaucoma.