Retinal nerve fiber layer thickness measurements with scanning laser polarimetry predict glaucomatous visual field loss
Retinal nerve fiber layer thickness measurements with scanning laser polarimetry predict glaucomatous visual field loss
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DOI：
10.1016/j.ajo.2004.05.072
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发表时间：
2004-10-01
影响因子：
4.2
通讯作者：
Zangwill, LM
中科院分区：
文献类型：
--
作者：
Mohammadi, K;Bowd, C;Zangwill, LM
目的：评估用扫描激光偏振仪获得的基线视网膜神经纤维层(RNFL)测量是否可以预测青光眼可疑眼的重复性青光眼视野损害的发生。设计：队列研究。方法：受试者来自UCSD青光眼纵向诊断创新研究(DIGS)。对160名标准自动视野计(SAP)视野正常的青光眼可疑患者进行了研究。研究眼在随访期间根据连续三个青光眼视野的发展情况分为转换组和非转换组。单变量和多变量Cox比例风险模型包括SLP参数、眼压、垂直杯盘比、立体摄影评估青光眼或非青光眼、男性、角膜厚度和视野指数，以确定哪些SLP、RNFL和眼睛参数可以预测视野转换。结果：16只眼(10%)发生了可重复的视野损害(转换)，144只眼(90%)没有发生(未转换)。中转眼平均(95%CI)随访至视野转换时间为2.7(1.7，3.6)年。未转复眼的平均随访时间为3.8(3.5，4.1)年。在13个被检查的基线SLP参数中有4个和基线SAP平均偏差(MD)、SAP图形标准偏差(PSD)和青光眼立体摄影评估是有意义的单变量视野转换预测因素。在调整了年龄、眼压和CCT的多变量模型中，SLP参数下标比、椭圆调制和UCSD线性判别函数(LDF)是视野转换的显著预测因素。当SAP、PSD和立体摄影评估也包括在多变量模型中时，不良比率和UCSD LDF仍然是视野损失的独立预测因素。结论：基线SLP较薄的RNFL测量是视野损害的独立预测因素。除了较薄的SLP RNFL测量外，较高的基线SAP PSD和基线青光眼立体摄影评估均导致可疑青光眼患者出现异常视野的风险增加。即使在模型中包括了年龄、眼压、CCT、垂直杯盘比和SAP PSD，SLP RNFL测量仍可独立预测未来的视力损失。(C)2004，由Elsevier Inc.保留所有权利。
PURPOSE: To assess whether baseline retinal nerve fiber layer (RNFL) measurements obtained with a scanning laser polarimeter, the GDx Nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) are predictive of development of repeatable glaucomatous visual field damage in glaucoma suspect eyes.DESIGN: Cohort study.METHODS: Participants were recruited from the UCSD longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). One eye from each of 160 glaucoma suspects with normal standard automated perimetry (SAP) visual fields at baseline was studied. Study eyes were divided into convert and nonconvert groups based on the development of three consecutive glaucomatous visual fields during follow-up. SLP parameters, IOP, vertical cup disk ratio, stereophotograph assessment as glaucoma or nor, mal, corneal thickness, and visual field indices were included in univariate and multivariate Cox proportional hazards models to determine which SLP RNFL and ocular parameters were predictive of visual field conversion.RESULTS: Sixteen (10%) eyes developed repeatable visual field damage (converts) and 144 (90%) did not (nonconverts). Mean (95%CI) follow,up time until visual field conversion for convert eyes was 2.7 (1.7, 3.6) years. Mean total follow-up of nonconvert eyes was 3.8 (3.5, 4.1) years. Four out of thirteen examined baseline SLP parameters and baseline SAP Mean Deviation (MD), SAP Pattern Standard Deviation (PSD), and glaucomatous stereophotograph assessment were significant univariate predictors of visual field conversion. In multivariate models adjusted for age, IOP and CCT, SLP parameters inferior ratio, ellipse modulation, and UCSD linear discriminant function (LDF) were significant predictors of visual field conversion. When SAP PSD and stereophotograph assessment were also included in the multivariate model inferior ratio and UCSD LDF remained independently predictive of visual field loss.CONCLUSIONS: Thinner baseline SLP RNFL measurements were independent predictors of visual field damage. In addition to thinner SLP RNFL measurements, higher baseline SAP PSD, and baseline glaucomatous stereophotograph assessment each contributed to an increased risk of the development of abnormal visual fields in glaucoma suspect patients. SLP RNFL measurements were independently predictive of future visual loss even when age, IOP, CCT, vertical cup disk ratio, and SAP PSD were included in the model. (C) 2004 by Elsevier Inc. All rights reserved.