Discriminating ability of spectral domain optical coherence tomography in different stages of glaucoma
Discriminating ability of spectral domain optical coherence tomography in different stages of glaucoma
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DOI：
10.1016/j.sjopt.2012.09.001
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发表时间：
2013-01-01
影响因子：
0.4
通讯作者：
Helal, Randa Mohamed
中科院分区：
文献类型：
--
作者：
Elbendary, Amal M.;Helal, Randa Mohamed
目的：为探讨光谱域光学相干断层扫描（SD-OCT）测量视网膜神经纤维层（RNFL）厚度对青光眼不同分期的鉴别能力，选取正常眼30例，青光眼患者150例。根据视野指数（VFI）将青光眼分为早期、中度和重度。对所有患者进行完整的眼科检查、白色对白色视野检查和SD-OCT。记录象限RNFL厚度和平均厚度。结果：平均、下、上级RNFL厚度是区分正常与早期青光眼（AUC：0.91-86）、早期与中度青光眼（AUC：0.77-0.70）、中度与重度青光眼（AUC：0.85-83）的最佳参数。平均RNFL损失在早期青光眼中为18%，在中度青光眼中为28%，在重度青光眼中为41%。早期损伤往往是局灶性的，在下象限。平均VFI和平均RNFL损失之间检测到显着的相关性。根据平均RNFL损失将青光眼重新划分为早期：>= 97.5 μ，中度：< 97.5-72.5 μ和重度：< 72.5 μ。结论：SD-OCT测量的RNFL厚度可以区分青光眼的三个阶段。RNFL损失可以与视野损失相关。未来基于OCT的青光眼分期，与视野检查无关是可能的。
Purpose: To determine the discriminating ability of retinal nerve fiber layer (RNFL) thickness measured with spectral-domain optical coherence tomography (SD-OCT) in different stages of glaucoma.Patients and methods: Thirty normal, 150 glaucomatous eyes were included. Glaucomatous eyes were graded into early, moderate and severe stages according to one of the global indices called visual field index (VFI). Complete ophthalmic examination, white on white perimetry and SD-OCT were done for all patients. RNFL thickness of quadrants and average thickness were recorded. Area under receiver operating characteristic curves (AUCs) were used to assess the performance of OCT parameters.Results: Average, inferior and superior RNFL thickness were the best parameters to discriminate normal from early glaucoma (AUC: 0.91-86), early from moderate (AUC: 0.77-0.70) and moderate from severe (AUC: 0.85-83). Average RNFL loss was 18% in early glaucoma, 28% in moderate glaucoma and 41% in severe glaucoma. Early damage tends to be focal and in the lower quadrant. A significant correlation was detected between mean VFI and mean RNFL loss. Glaucoma was restaged according to average RNFL loss into early: >= 97.5 mu, moderate: < 97.5-72.5 mu and severe: < 72.5 mu.Conclusion: RNFL thickness measured with SD-OCT could discriminate the three stages of glaucoma. RNFL loss can be correlated to visual field loss. Future OCT-based staging of glaucoma, adjunctive to perimetry is possible.`