Evaluation of Macular and Retinal Ganglion Cell Count Estimates for Detecting and Staging Glaucoma.
Evaluation of Macular and Retinal Ganglion Cell Count Estimates for Detecting and Staging Glaucoma.
复制标题
用于青光眼检测和分期的黄斑和视网膜神经节细胞计数估计值的评估
DOI：
10.3389/fmed.2021.740761
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发表时间：
2021
影响因子：
3.9
通讯作者：
Zhong H
中科院分区：
文献类型：
--
作者：
Wu Y;Cun Q;Tao Y;Yang W;Wei J;Fan D;Zhang Y;Chen Q;Zhong H
用途：探讨黄斑视网膜神经节细胞（mRGC）和视网膜神经节细胞（eRGC）在青光眼诊断和分期中的临床意义。方法：本研究为横断面研究。所有入组受试者均接受标准自动视野检查（SAP）和光学相干断层扫描（OCT）检查。SAP检测采用瑞典交互阈值算法（SITA）-FAST检测策略和24-2、10-2检测程序。根据三个公式计算视野参数和OCT参数，以获得eRGC和mRGC 1或mRGC 2。比较eRGC、mRGC 1和mRGC 2估计值对青光眼分期的有效性。采用受试者工作特征曲线（ROC）分析各参数诊断青光眼的敏感性和特异性。结果：共119只眼纳入分析。与健康对照组相比，青光眼患者的eRGC、mRGC 1和mRGC 2估计值显著降低。随着青光眼的进展，eRGC、mRGC 1和mRGC 2估计值逐渐降低。在视野前青光眼中，mRGC 1、mRGC 2和eRGC分别降低了13.2%、14.5%和18%。在青光眼的轻度阶段，mRGC 1、mRGC 2和eRGC分别减少28%、34%和38%。在晚期青光眼中，mRGC 1、mRGC 2和eRGC分别减少81%、85%和92%。视网膜神经节细胞（RGC）在黄斑内的丢失比例接近黄斑外。特异性为95%时，eRGC、mRGC 1和mRGC 2的灵敏度分别为95.51%、86.52%和87.64%。结构参数黄斑神经节细胞复合体厚度和视网膜神经纤维层（RNFL）的敏感性分别为98.88%和95.51%。功能参数平均偏差（24-2）和视野指数（VFI）的敏感性分别为80.90%和73.03%。mRGC 1、mRGC 2和eRGC的ROC曲线下面积分别为0.982、0.972和0.995（P < 0.0001）。结论：视网膜神经节细胞、mRGC 1、mRGC 2的检测对青光眼的分期及诊断有一定的参考价值。Macular RGC认为黄斑区结构和功能损伤的整合可作为评价青光眼黄斑损害的敏感指标，对青光眼的诊断和进展管理具有重要意义。
Purpose: To investigate the clinical significance of macular estimated retinal ganglion cell (mRGC) and estimated retinal ganglion cell (eRGC) in the diagnosis and staging of glaucoma. Methods: This is a cross-section study. All enrolled subjects underwent standard automated perimetry (SAP) and optical coherence tomography (OCT) examination. Swedish Interactive Threshold Algorithm (SITA)-FAST detection strategy and 24-2, 10-2 detection programs were employed in SAP assessment. The visual-field parameters and OCT parameters were calculated according to three formulas to obtain the eRGC and mRGC1 or mRGC2. The efficiency of eRGC, mRGC1, and mRGC2 estimates for the staging of glaucoma was compared. The sensitivity and specificity of each parameter for diagnosis of glaucoma were analyzed using the receiver operating characteristic (ROC) curve. Results: A total of 119 eyes were included in the analysis. Compared with the healthy controls, eRGC, mRGC1, and mRGC2 estimates were significantly decreased in patients with glaucoma. As glaucoma progressed, eRGC, mRGC1, and mRGC2 estimates were gradually reduced. In preperimetric glaucoma, mRGC1, mRGC2, and eRGC were reduced by 13.2, 14.5, and 18%, respectively. In the mild stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 28, 34, and 38%, respectively. In the advanced stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 81, 85, and 92% respectively. The proportion of retinal ganglion cell (RGC) loss in the macula was close to that outside the macula. The specificity at 95% gave a sensitivity of 95.51, 86.52, and 87.64% for eRGC, mRGC1, and mRGC2, respectively. The sensitivity of structural parameters macular ganglion cell complex thickness and retinal nerve fiber layer (RNFL) were 98.88 and 95.51%, respectively. The sensitivity of functional parameters mean deviation (24-2) and visual field index (VFI) were 80.90 and 73.03%, respectively. The area under ROC curve of mRGC1, mRGC2, and eRGC were 0.982, 0.972, and 0.995 (P < 0.0001), respectively. Conclusion: Estimated retinal ganglion cell, mRGC1, and mRGC2 provide value to the staging of glaucoma and better diagnostic performance. Macular RGC estimatesthat integration of both structural and functional damages in macular may serve as a sensitive indicator for assessing macular damage in glaucoma and are of importance for the diagnosis and progression management of glaucoma.
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影响因子：
4.2
作者：
Medeiros FA;Zangwill LM;Anderson DR;Liebmann JM;Girkin CA;Harwerth RS;Fredette MJ;Weinreb RN
通讯作者：
Weinreb RN
DOI：
10.1001/jama.2014.3192
发表时间：
2014-05-14
期刊：
JAMA
影响因子：
--
作者：
Weinreb RN;Aung T;Medeiros FA
通讯作者：
Medeiros FA
影响因子：
17.8
作者：
Hood DC;Raza AS;de Moraes CG;Liebmann JM;Ritch R
通讯作者：
Ritch R
影响因子：
4.4
作者：
Strouthidis, Nicholas G.;Scott, Andrew;Garway-Heath, David F.
通讯作者：
Garway-Heath, David F.
影响因子：
4.4
作者：
Hood, Donald C.;Raza, Ali S.;Ritch, Robert
通讯作者：
Ritch, Robert