Evaluation of Macular Thickness and Peripapillary Retinal Nerve Fiber Layer Thickness for Detection of Early Glaucoma Using Spectral Domain Optical Coherence Tomography
Evaluation of Macular Thickness and Peripapillary Retinal Nerve Fiber Layer Thickness for Detection of Early Glaucoma Using Spectral Domain Optical Coherence Tomography
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DOI：
10.1097/ijg.0b013e3181e079ed
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发表时间：
2011-04-01
影响因子：
2
通讯作者：
Sugiyama, Kazuhisa
中科院分区：
文献类型：
--
作者：
Nakatani, Yusuke;Higashide, Tomomi;Sugiyama, Kazuhisa
目的：为评价光谱域光学相干断层扫描（SD-OCT）黄斑参数和视乳头周围视网膜神经纤维层（RNFL）参数对早期青光眼的诊断价值，材料与方法：对32例早期青光眼患者（包括视野前青光眼）和32例正常对照者的1只眼进行3次光谱域OCT黄斑扫描和视乳头周围RNFL扫描。通过受试者工作特征曲线下面积（AROC）和固定特异度下的敏感性确定各参数检测早期青光眼的区分能力。通过线性回归分析评估OCT数据与视野缺损的相关性。结果：除黄斑中心凹、上级象限和下象限（12、3、6、7、11点）以及RNFL扫描中的平均RNFL厚度外，早期青光眼和正常人的所有参数均存在显著差异。基于AROC的最佳参数和特异性> 90%的敏感性为黄斑参数中的颞外黄斑厚度（AROC，0.79;敏感性，63%）和RNFL参数中的下象限（AROC，0.82;敏感性，53%）。下黄斑内容积与平均偏差的相关性最高（r = 0.50，P < 0.001）。平均组内相关系数在黄斑扫描中为0.96，在RNFL扫描中为0.84。黄斑区厚度的重测变异范围为2.3 ~ 10.1 μ m，黄斑区体积的重测变异范围为0 ~ 0.06mm（3），视网膜神经纤维层厚度的重测变异范围为5.8 ~ 18.9 μ m。
Purpose: To evaluate the diagnostic ability of macular parameters and peripapillary retinal nerve fiber layer (RNFL) parameters for early glaucoma using spectral domain optical coherence tomography (SD-OCT).Materials and methods: One eye from 32 early glaucoma patients (including preperimetric glaucoma) and 32 normal participants underwent macular scans and peripapillary RNFL scans with SD-OCT 3 times on the same day. The discrimination power of each parameter to detect early glaucoma was determined by areas under receiver operating characteristics curve (AROC) and sensitivity at fixed specificity. Correlation of OCT data with visual field defects was evaluated by linear regression analysis. Reproducibility was also evaluated.Results: Significant differences between early glaucoma and normal participants were found for all parameters except fovea in macular scans and in the superior and inferior quadrants, at 12, 3, 6, 7, 11 o'clock, and average RNFL thickness in RNFL scans. The best parameters based on AROC and sensitivity at a specificity of > 90% were temporal outer macula thickness (AROC, 0.79; sensitivity, 63%) in macular parameters and inferior quadrant (AROC, 0.82; sensitivity, 53%) in RNFL parameters. The highest correlation with mean deviation was found in inferior inner macular volume (r = 0.50, P < 0.001). The mean intraclass correlation coefficient was 0.96 in macular scans and 0.84 in RNFL scans. Test-retest variability ranged from 2.3 to 10.1 mu m in macular thickness, 0 to 0.06mm(3) in macular volume, and 5.8 to 18.9 mu m in RNFL thickness.Conclusion: For the diagnosis of early glaucoma by SD-OCT, macular parameters had high discriminating power and high reproducibility comparable with peripapillary RNFL parameters.