Correlation of retinal nerve fiber layer thickness and visual fields in glaucoma: a broken stick model.
Correlation of retinal nerve fiber layer thickness and visual fields in glaucoma: a broken stick model.
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DOI：
10.1016/j.ajo.2014.01.014
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发表时间：
2014-05
影响因子：
4.2
通讯作者：
Chen, Teresa C.
中科院分区：
文献类型：
--
作者：
Alasil, Tarek;Wang, Kaidi;Yu, Fei;Field, Matthew G.;Lee, Hang;Baniasadi, Neda;de Boer, Johannes F.;Coleman, Anne L.;Chen, Teresa C.
确定视网膜神经纤维层（RNFL）厚度，在该厚度上，视野（VF）损伤可被检测到并与结构损失相关。回顾性横断面研究。从某学术机构招募了87名健康受试者和108名青光眼受试者（每名受试者一只眼）。所有患者进行了VF检查（瑞典交互式阈值算法24-2测试的Humphrey视野分析仪750i；卡尔蔡司Meditec，都柏林，CA）和光谱域光学相干断层扫描RNFL扫描（Spectralis, Heidelberg Engineering, Heidelberg，德国）。RNFL厚度值与VF阈值的比较显示，在RNFL厚度高时，VF阈值呈平稳状态，而在RNFL厚度低时，VF阈值急剧下降。利用断棒统计分析来估计RNFL厚度值与VF缺陷相关的临界点。对于高于和低于临界点的数据，计算结构和功能之间关联的斜率。与初始VF损失相关的RNFL平均厚度值为89 μm。与初始相应的较差VF损失相关的较优RNFL厚度值为100 μm。与初始相应的高VF损失相关的低RNFL厚度值为73 μm。上述临界点以上和以下的所有斜率之间的差异具有统计学意义（p<0.001）。在开角型青光眼中，在功能性视野缺陷被检测到之前，大量的RNFL变薄或结构丧失似乎是必要的。
To determine the retinal nerve fiber layer (RNFL) thickness at which visual field (VF) damage becomes detectable and associated with structural loss. Retrospective cross-sectional study. Eighty seven healthy and 108 glaucoma subjects (one eye per subject) were recruited from an academic institution. All patients had VF examinations (Swedish Interactive Threshold Algorithm 24-2 test of the Humphrey visual field analyzer 750i; Carl Zeiss Meditec, Dublin, CA) and spectral domain optical coherence tomography RNFL scans (Spectralis, Heidelberg Engineering, Heidelberg, Germany). Comparison of RNFL thicknesses values with VF threshold values showed a plateau of VF threshold values at high RNFL thickness values and then a sharp decrease at lower RNFL thickness values. A broken stick statistical analysis was utilized to estimate the tipping point at which RNFL thickness values are associated with VF defects. The slope for the association between structure and function was computed for data above and below the tipping point. The mean RNFL thickness value that was associated with initial VF loss was 89 μm. The superior RNFL thickness value that was associated with initial corresponding inferior VF loss was 100 μm. The inferior RNFL thickness value that was associated with initial corresponding superior VF loss was 73 μm. The differences between all the slopes above and below the aforementioned tipping points were statistically significant (p<0.001). In open angle glaucoma, substantial RNFL thinning or structural loss appears to be necessary before functional visual field defects become detectable.
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