Diagnostic capability of Fourier-Domain optical coherence tomography in early primary open angle glaucoma
Diagnostic capability of Fourier-Domain optical coherence tomography in early primary open angle glaucoma
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DOI：
10.3760/cma.j.issn.0366-6999.2010.15.017
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发表时间：
2010-08-05
影响因子：
6.1
通讯作者：
Cai Yu
中科院分区：
文献类型：
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作者：
Fang Yuan;Pan Ying-zi;Cai Yu
光学相干断层扫描（OCT）是一种可以定量检测视盘和视网膜结构的高分辨率非接触成像方式。本研究旨在评估视盘参数、视网膜神经纤维层厚度和神经节细胞复合体（GCC）对早期原发性开角型青光眼（POAG）患者的诊断能力，采用傅里叶域OCT （FD-OCT）新技术。方法采用观察性横断面研究方法，将早期围周性损伤POAG患者和正常人分为两组。所有患者除进行全面眼科检查外，还进行FD-OCT和视野检查。研究各参数的受试者工作特征曲线（ROC）。采用任意截止值对所有单一参数和选择的组合参数进行敏感性和特异性评价，以区分正常和早期青光眼、受者工作特征曲线下面积（AROC）和阳性、阴性似然比。结果分析34例早期POAG患者34只眼和42例正常人42只眼。杯/盘（C/D）垂直比的灵敏度和阳性似然比分别为79.4%和88.2%（95%和85%）和33.4和7.4。各单项参数中，C/D垂直比AROC最高，为0.930。乳头周围RNFL的平均厚度为3.45 mm， AROC在所有乳头周围RNFL参数中最高。在选择特异性和AROC上，GCC的敏感性不如C/D垂直比和RNFL at （3.45 mm）高。当C/D垂直比、3.45 mm的RNFL AT和边缘面积结合使用logistic诊断模型时，AROC提高到0.949，但与顶部单一参数C/D垂直比差异不显著。结论FD-OCT获得的关键参数能够显示POAG患者与正常人视盘、RNFL和GCC厚度的显著差异。根据敏感性、特异性、似然比和AROC， FD-OCT早期诊断POAG的前3个参数为C/D垂直比、RNFL AT （3.45 mm）和边缘面积。中华医学杂志2010；123 (15): 2045 - 2050
Background Optical coherence tomography (OCT) is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure. This study was designed to evaluate the diagnostic capability of parameters of the optic disc, retinal nerve fiber layer thickness, and ganglion cell complex (GCC) using a new technology called Fourier-domain OCT (FD-OCT) for early primary open angle glaucoma (POAG) patients.Methods Two groups of patients, early perimetric damage POAG and normal subjects were included in this observational cross-sectional study. All patients underwent FD-OCT and visual field examination in addition to full ophthalmic examinations. Receiver operating characteristic curves (ROC) were studied for all parameters. The sensitivity and specificity for distinguishing between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves (AROC) and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters using arbitrary cutoffs.Results Thirty-four eyes of 34 early POAG patients and 42 eyes of 42 normal subjects were analyzed. Cup/disc (C/D) vertical ratio presented the best sensitivity and positive likelihood ratio for selected specificities (95% and 85%) which were 79.4% and 88.2%, 33.4 and 7.4, respectively. Among all single parameters, the C/D vertical ratio demonstrated the highest AROC which was at 0.930. The average thickness of circumpapillary RNFL on 3.45 mm showed the highest AROC among all of the peripapillary RNFL parameters. The sensitivity at selected specificity and AROC of GCC were not as high as C/D vertical ratio and RNFL AT on 3.45 mm. When the C/D vertical ratio, RNFL AT on 3.45 mm, and rim area were combined using a logistical diagnostic model, the AROC was raised to 0.949 but not significantly different from the top single parameter, C/D vertical ratio.Conclusions The key parameters obtained by FD-OCT were able to show the significant differences of optic discs, thickness of RNFL and GCC between POAG patients and normal subjects. According to sensitivity, specificity, likelihood ratio and AROC, the top three parameters from FD-OCT for early diagnosis of POAG were C/D vertical ratio, RNFL AT on 3.45 mm, and the rim area. Chin Med J 2010;123(15):2045-2050