Waveform Analysis of Ocular Blood Flow and the Early Detection of Normal Tension Glaucoma
Waveform Analysis of Ocular Blood Flow and the Early Detection of Normal Tension Glaucoma
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DOI：
10.1167/iovs.13-12930
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发表时间：
2013-11-01
影响因子：
4.4
通讯作者：
Nakazawa, Toru
中科院分区：
文献类型：
--
作者：
Shiga, Yukihiro;Omodaka, Kazuko;Nakazawa, Toru
目的。观察视神经头血流（BF）波形变化，评价其对正常张力性青光眼（NTG）的诊断价值。本研究纳入61例NTG患者的61只眼和21只年龄匹配的健康对照。根据视野缺损的进展情况，将NTG眼分为轻度（平均偏差[MD]大于-6.0分贝[dB]）、中度（MD在-6.0 ~ -12.0分贝之间）和重度（MD小于-12.0分贝）三组。ONH BF分析采用激光散斑流成像（LSFG）进行，包括波形变量，如歪斜、加速时间指数（ATI）和井喷时间。在ONH中，尽管四组的系统特征相似，但NTG组的LSFG偏度变量显著低于对照组（P < 0.001）， ATI显著高于对照组（P < 0.01）。轻度NTG组差异最为显著。多元线性回归分析显示，MD、乳头周围视网膜神经纤维层平均厚度、脉搏率是斜视和ATI的预测因素。受试者工作特征（ROC）曲线分析也显示，偏度（ROC曲线下面积，0.89）和ATI （ROC曲线下面积，0.80）是区分正常眼睛和轻度NTG眼睛的最大力量。结论。这些结果表明，LSFG测量ONH BF的波形变化可以区分健康眼睛和NTG眼睛，特别是轻度NTG眼睛。
PURPOSE. To investigate waveform changes in blood flow (BF) in the optic nerve head (ONH) and to evaluate their usefulness in identifying normal tension glaucoma (NTG).METHODS. Sixty-one eyes of 61 patients with NTG and 21 eyes of age-matched healthy control subjects were included in this study. The NTG eyes were divided into the following three groups based on the progression of their visual field defects: mild (mean deviation [MD] greater than -6.0 decibels [dB]), moderate (MD between -6.0 and -12.0 dB), and severe (MD less than -12.0 dB). The ONH BF analysis was performed with laser speckle flowgraphy (LSFG) and included waveform variables such as skew, acceleration time index (ATI), and blowout time.RESULTS. In the ONH, LSFG skew variables were significantly lower in the NTG eyes than in the control eyes (P < 0.001), and ATI was significantly higher (P < 0.01), despite similar systemic characteristics in the four groups. The differences were most marked in the mild NTG group. Multiple linear regression analysis showed that MD, average thickness of the circumpapillary retinal nerve fiber layer, and pulse rate were predictive factors for both skew and ATI. A receiver operating characteristic (ROC) curve analysis also revealed that skew (area under the ROC curve, 0.89) and ATI (area under the ROC curve, 0.80) had the greatest power to differentiate normal eyes from eyes with mild NTG. CONCLUSIONS. These results suggest that LSFG measurements of waveform changes in ONH BF can differentiate healthy eyes from eyes with NTG, particularly those with mild NTG.