Baseline OCT Measurements in the Idiopathic Intracranial Hypertension Treatment Trial, Part I: Quality Control, Comparisons, and Variability
Baseline OCT Measurements in the Idiopathic Intracranial Hypertension Treatment Trial, Part I: Quality Control, Comparisons, and Variability
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DOI：
10.1167/iovs.14-14960
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发表时间：
2014-12-01
影响因子：
4.4
通讯作者：
Werner, John S.
中科院分区：
文献类型：
--
作者：
Auinger, Peggy;Durbin, Mary;Werner, John S.
目的。光学相干断层扫描（OCT）已被用于研究单部位乳头水肿，主要是回顾性研究。在一项前瞻性的多地点临床试验中，我们研究了提供视神经头和视网膜厚度和体积测量的光谱域OCT （SD-OCT）是否能够可靠地显示由乳头水肿引起的结构变化。在特发性颅内高压治疗试验（IIHTT）中，126名轻度视野丧失的受试者使用Cirrus SD-OCT进行视盘和黄斑扫描。使用专有的商业和定制3d分割算法对图像进行分析，计算视网膜神经纤维层（RNFL）、视网膜总厚度（TRT）、视神经头体积（ONHV）和视网膜神经节细胞层（GCL）厚度。我们通过眼间比较和两种方法结果之间的相关性来评估变异性。在90%的眼睛中，RNFL平均厚度为正常对照的95%，RNFL、TRT、ONH高度和ONHV在眼间比较中显示出很强的相关性（r > 0.8）。除了专有的GCL厚度外，两种方法的OCT参数重复测试的可变性都很低，类内相关性为bb0 0.9。专有算法衍生的RNFL、TRT和GCL厚度测量对所有眼睛的失败率分别为10%、16%和20%，这在3d分割衍生的测量中并不常见。通过两种方法，只有7%的眼睛GCL变薄，小于正常年龄匹配对照眼睛的5%。光谱域OCT提供了可靠的连续变量和定量评估乳头水肿引起的结构改变。
PURPOSE. Optical coherence tomography (OCT) has been used to investigate papilledema in single-site, mostly retrospective studies. We investigated whether spectral-domain OCT (SD-OCT), which provides thickness and volume measurements of the optic nerve head and retina, could reliably demonstrate structural changes due to papilledema in a prospective multisite clinical trial setting.METHODS. At entry, 126 subjects in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) with mild visual field loss had optic disc and macular scans, using the Cirrus SD-OCT. Images were analyzed by using the proprietary commercial and custom 3D-segmentation algorithms to calculate retinal nerve fiber layer (RNFL), total retinal thickness (TRT), optic nerve head volume (ONHV), and retinal ganglion cell layer (GCL) thickness. We evaluated variability, with interocular comparison and correlation between results for both methods.RESULTS. The average RNFL thickness > 95% of normal controls in 90% of eyes and the RNFL, TRT, ONH height, and ONHV showed strong (r > 0.8) correlations for interocular comparisons. Variability for repeated testing of OCT parameters was low for both methods and intraclass correlations > 0.9 except for the proprietary GCL thickness. The proprietary algorithm-derived RNFL, TRT, and GCL thickness measurements had failure rates of 10%, 16%, and 20% for all eyes respectively, which were uncommon with 3D-segmentation-derived measurements. Only 7% of eyes had GCL thinning that was less than fifth percentile of normal age-matched control eyes by both methods.CONCLUSIONS. Spectral-domain OCT provides reliable continuous variables and quantified assessment of structural alterations due to papilledema.