Measuring Hemoglobin Levels in the Optic Nerve Head: Comparisons with Other Structural and Functional Parameters of Glaucoma
Measuring Hemoglobin Levels in the Optic Nerve Head: Comparisons with Other Structural and Functional Parameters of Glaucoma
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DOI：
10.1167/iovs.12-10761
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发表时间：
2013-01-01
影响因子：
4.4
通讯作者：
Ferreras, Antonio
中科院分区：
文献类型：
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作者：
Gonzalez de la Rosa, Manuel;Gonzalez-Hernandez, Marta;Ferreras, Antonio
目的.我们评估并比较了一种新的方法测量血红蛋白（Hb）水平在视神经乳头（ONH）的视野评估，扫描激光检眼镜（HRT），扫描激光偏振（GDx），光学相干断层扫描（OCT）诊断青光眼的能力。健康眼（n = 102）和青光眼眼（n = 101）进行可靠的Oculus Spark视野检查，并使用HRT、GDx和Cirrus OCT进行成像。此外，使用非散瞳眼底照相机采集ONH彩色图像。然后使用拉古纳ONhE程序计算ONH的24个区段中的每个区段中的Hb量。计算95%固定特异性时的灵敏度、诊断一致性和最佳诊断能力参数之间的线性相关性。拉古纳程序的青光眼判别函数（GDF），评价垂直中间扇区和中心/周边Hb量斜率的Hb，产生了89.1%的敏感性和95.1%的特异性，这是上级或类似于其他测试。最佳GDF诊断一致性是OCT垂直杯盘（C/D）比（kappa = 0.772）和最终相位Spark模式SD（kappa = 0.672）。Hb水平与Spark平均灵敏度密切相关（第一阶段0.70，最终阶段0.71）。Hb与HRT的Reinhard OW Burk判别函数（0.56）、GDx的神经纤维指标（-0.64）和OCT的垂直C/D比值（0.71）也具有良好的相关性。通过ONH照片的颜色分析评价的Hb水平具有高再现性、高灵敏度-特异性平衡，并且与其他结构和功能测试具有中度至高度一致性。（Invest Ophthalmol维斯科学。2013;54：482-489）DOI：10.1167/iovs.12-10761
PURPOSE. We evaluated and compared the ability of a new method for measuring hemoglobin (Hb) levels at the optic nerve head (ONH) to that of visual field evaluation, scanning laser ophthalmoscopy (HRT), scanning laser polarimetry (GDx), and optical coherence tomography (OCT) for diagnosing glaucoma.METHODS. Healthy eyes (n = 102) and glaucomatous eyes (n = 101) underwent reliable Oculus Spark perimetry, and imaging with the HRT, GDx, and Cirrus OCT. In addition, ONH color images were acquired with a non-mydriatic fundus camera. The Laguna ONhE program then was used to calculate the Hb amount in each of 24 sectors of the ONH. Sensitivities at 95% fixed specificity, diagnostic agreement, and linear correlations between parameters with the best diagnostic ability were calculated.RESULTS. The glaucoma discriminant function (GDF) of the Laguna program, evaluating Hb in the vertical intermediate sectors and center/periphery Hb amount slope, yielded an 89.1% sensitivity and 95.1% specificity, which was superior or similar to the other tests. The best GDF diagnostic agreement was for the OCT-vertical cup-to-disc (C/D) ratio (kappa = 0.772) and the final phase Spark pattern SD (kappa = 0.672). Hb levels correlated strongly with the Spark mean sensitivity (first phase 0.70, final phase 0.71). Hb also correlated well with the Reinhard OW Burk discriminant function of the HRT (0.56), nerve fiber indicator of GDx (-0.64), and vertical C/D ratio of OCT (0.71).CONCLUSIONS. Hb levels evaluated by color analysis of ONH photographs had high reproducibility, a high sensitivity-specificity balance, and moderate to strong agreement with other structural and functional tests. (Invest Ophthalmol Vis Sci. 2013;54:482-489) DOI: 10.1167/iovs.12-10761