Combining nerve fiber layer parameters to optimize glaucoma diagnosis with optical coherence tomography
Combining nerve fiber layer parameters to optimize glaucoma diagnosis with optical coherence tomography
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DOI：
10.1016/j.ophtha.2008.01.011
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发表时间：
2008-08-01
期刊：
影响因子：
13.7
通讯作者：
Huang, David
中科院分区：
文献类型：
--
作者：
Lu, Ake Tzu-Hui;Wang, Mingwu;Huang, David
目的：为了确定Stratus光学相干断层扫描（OCT）视网膜神经纤维层（RNFL）厚度参数检测青光眼的最佳组合。设计：观察性横断面研究。参与者：89名年龄匹配的正常和周边型青光眼参与者参加了青光眼高级成像研究。方法：使用Zeiss Stratus OCT系统获得每位参与者双眼的视乳头周围RNFL厚度。假设镜像对称，将右眼和左眼时钟时间数据一起分析。RNFL诊断参数采用或逻辑或与逻辑方法进行组合。主要结果测量：受试者工作特征曲线下面积（AROC）、敏感性和特异性用于评估诊断性能。总体平均RNFL厚度具有最高的AROC值（0.89），其次是下象限和上级象限（分别为0.88和0.86）。具有最佳AROC值的时钟小时位于下象限和上级象限。最高的AROC（0.92）是通过整体，下，和上级象限RNFL厚度的或逻辑组合实现的。3参数组合显著优于单独的总体平均值（P = 0.01）。增加更多的象限或时钟小时的组合降低了诊断performance.Conclusions：最好的独立诊断策略，为Stratus OCT RNFL数据是分类为昏迷的眼睛，如果整体，下象限，或上级象限RNFL厚度平均值低于正常。
Purpose: To identify the best combination of Stratus optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness parameters for the detection of glaucoma.Design: Observational cross-sectional study.Participants: Eighty-nine age-matched normal and perimetric glaucoma participants enrolled in the Advanced Imaging for Glaucoma Study.Methods: The Zeiss Stratus OCT system was used to obtain the circumpapillary RNFL thickness in both eyes of each participant. Right and left eye clock-hour data are analyzed together, assuming mirror-image symmetry. The RNFL diagnostic parameters were combined using either or-logic or and-logic approaches.Main Outcome Measures: Area under the receiver operating characteristic curve (AROC), sensitivity, and specificity are used to evaluate diagnostic performance.Results: Overall average RNFL thickness has the highest AROC value (0.89) of all single parameters evaluated, followed by the inferior and superior quadrants (0.88 and 0.86, respectively). The clock hours with the best AROC values are in the inferior and superior quadrants. The highest AROC (0.92) was achieved by the or-logic combination of overall, inferior, and superior quadrant RNFL thicknesses. The 3-parameter combination was significantly better than the overall average alone (P = 0.01). The addition of more quadrants or clock hours to the combination reduced diagnostic performance.Conclusions: The best stand-alone diagnostic strategy for Stratus OCT RNFL data is to classify an eye as glaucomatous if the overall, inferior quadrant, or superior quadrant RNFL thickness average is below normal.