The ISNT rule and differentiation of normal from glaucomatous eyes
The ISNT rule and differentiation of normal from glaucomatous eyes
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DOI：
10.1001/archopht.124.11.1579
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发表时间：
2006-11-01
影响因子：
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通讯作者：
Liebmann, Jeffrey M.
中科院分区：
文献类型：
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作者：
Harizman, Noga;Oliveira, Cristiano;Liebmann, Jeffrey M.
目的：为了确定是否ISNT规则（即正常的眼睛表现出一个特征性的配置为盘边缘厚度的下>=上级>=鼻>=颞），广泛用于临床评价的视神经乳头，可以区分正常从hemocomatous eyes.Methods：所有受试者进行了完整的眼睛检查，包括消色差自动视野检查，同时立体光盘摄影，共焦扫描激光检眼镜。眼睛正常的受试者没有青光眼或高眼压的证据，视野测量正常。青光眼受试者具有可再现的视野缺损。每例受试者的一只眼睛随机入组。ISNT规则进行了评估，在3，6，9，和12点钟positions.Results：66例正常眼（33黑色和33白色个人）和43与开角型青光眼（15黑色和28白色个人）的光盘照片的蒙面评价。66只正常眼中52只（79%）ISNT规则完整，43只青光眼眼中12只（28%）ISNT规则完整（P <0.001）。多元Logistic回归分析表明，青光眼与违反的ISNT规则的比值比为6.04（95%置信区间，1.74-20.95）调整后的年龄，种族是不是一个混杂因素，这种association.Conclusion：ISNT规则是有用的区分正常的视神经和不受种族。
Objective: To determine whether the ISNT rule (that normal eyes show a characteristic configuration for disc rim thickness of inferior >= superior >= nasal >= temporal), widely used for clinical evaluation of the optic nerve head, can differentiate normal from glaucomatous eyes.Methods: All subjects underwent complete eye examination, including achromatic automated perimetry, simultaneous stereoscopic disc photography, and confocal scanning laser ophthalmoscopy. Subjects with normal eyes had no evidence of glaucoma or ocular hypertension and had normal perimetry measurements. Subjects with glaucoma had a reproducible visual field defect. One eye from each subject was randomly enrolled. The ISNT rule was assessed by masked evaluation of disc photographs at the 3, 6, 9, and 12 o'clock positions.Results: Sixty-six subjects with normal eyes (33 black and 33 white individuals) and 43 with open-angle glaucoma (15 black and 28 white individuals) were enrolled. The ISNT rule was intact in 52 (79%) of 66 normal eyes and 12 (28%) of 43 glaucomatous eyes (P < .001). Multiple logistic regression indicated that the odds ratio for glaucoma associated with violation of the ISNT rule was 6.04 (95% confidence interval, 1.74-20.95) after adjustment for age; race was not a confounder of this association.Conclusion: The ISNT rule is useful in differentiating normal from glaucomatous optic nerves and is unaffected by race.