Spectral-Domain OCT: Helping the Clinician Diagnose Glaucoma A Report by the American Academy of Ophthalmology
Spectral-Domain OCT: Helping the Clinician Diagnose Glaucoma A Report by the American Academy of Ophthalmology
复制标题
DOI：
10.1016/j.ophtha.2018.05.008
复制
发表时间：
2018-11-01
期刊：
影响因子：
13.7
通讯作者：
Chen, Philip P.
中科院分区：
文献类型：
--
作者：
Chen, Teresa C.;Hoguet, Ambika;Chen, Philip P.
目的：回顾目前发表的关于使用谱域（SD）OCT帮助检测与青光眼诊断相关的变化的文献。方法：2014年6月11日、2016年11月7日、2017年8月8日和2018年4月19日进行了同行评审文献检索，在PubMed和科克伦图书馆数据库中，仅包括自上次青光眼成像眼科技术评估以来发表的文章，其中包括截至2006年2月的文章。对这708篇文章的摘要进行了检查，以排除综述和非英文文章。在应用纳入和排除标准后，选择了74篇文章，并由专门小组的方法学家（K.N.- M.）的情况下进行。根据证据的等级给他们打分。2篇文章被评为I级，57篇文章被评为II级，和15个III级articles were excluded.Results：光谱域OCT能够检测视网膜神经纤维层（RNFL），黄斑，视神经损伤的患者preperimetric和perimetric青光眼（I级和II级证据）。最常研究的单一参数是RNFL厚度。值得注意的是，RNFL厚度测量在仪器之间不可互换。各种市售SD OCT仪器具有相似的区分已知青光眼患者与正常受试者的能力。尽管软件协议不同，但所有SD OCT仪器都能够检测到主要影响视神经下、颞下、上级和上级颞区的相同典型模式的昏迷性RNFL丢失（II级证据）。在许多SD OCT仪器中，与对照组相比，青光眼患者的黄斑成像也可以检测到优先的下部、下部颞部和上级颞部变薄。最好的光盘参数检测昏迷性神经损伤是全球边缘面积，下缘面积，垂直杯盘比。研究表明，新的参考平面独立的视神经参数可能有相同或更好的检测能力相比，旧的参考平面依赖的光盘参数（II级证据）。结论：结构性青光眼损害可以检测SD OCT。视神经，RNFL，和黄斑参数可以帮助临床医生区分与青光眼患者相比，与正常人的解剖结构的变化。(C)2018年美国眼科学会
Purpose: To review the current published literature on the use of spectral domain (SD) OCT to help detect changes associated with the diagnosis of glaucoma.Methods: Searches of the peer-reviewed literature were conducted on June 11, 2014, November 7, 2016, August 8, 2017, and April 19, 2018, in the PubMed and Cochrane Library databases and included only articles published since the last glaucoma imaging Ophthalmic Technology Assessment, which included articles up until February 2006. The abstracts of these 708 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 74 articles were selected, and the panel methodologist (K.N.-M.) assigned ratings to them according to the level of evidence. Two articles were rated level I, 57 articles were rated level II, and the 15 level III articles were excluded.Results: Spectral-domain OCT is capable of detecting damage to the retinal nerve fiber layer (RNFL), macula, and optic nerve in patients with preperimetric and perimetric glaucoma (level I and II evidence). The most commonly studied single parameter was RNFL thickness. Of note, RNFL thickness measurements are not interchangeable between instruments. Various commercially available SD OCT instruments have similar abilities to distinguish patients with known glaucoma from normal subjects. Despite different software protocols, all SD OCT instruments are able to detect the same typical pattern of glaucomatous RNFL loss that affects primarily the inferior, inferior temporal, superior, and superior temporal regions of the optic nerve (level II evidence). Across many SD OCT instruments, macular imaging also can detect a preferential inferior, inferior temporal, and superior temporal thinning in patients with glaucoma compared with controls. Best disc parameters for detecting glaucomatous nerve damage are global rim area, inferior rim area, and vertical cup-to-disc ratio. Studies suggest that newer reference-plane independent optic nerve parameters may have the same or better detection capability when compared with older reference-plane dependent disc parameters (level II evidence).Conclusions: Structural glaucomatous damage can be detected by SD OCT. Optic nerve, RNFL, and macular parameters can help the clinician distinguish the anatomic changes that are associated with patients with glaucoma when compared with normal subjects. (C) 2018 by the American Academy of Ophthalmology