Vertical cup/disc ratio in relation to optic disc size: its value in the assessment of the glaucoma suspect
Vertical cup/disc ratio in relation to optic disc size: its value in the assessment of the glaucoma suspect
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DOI：
10.1136/bjo.82.10.1118
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发表时间：
1998-10-01
影响因子：
4.1
通讯作者：
Hitchings, RA
中科院分区：
文献类型：
--
作者：
Garway-Heath, DF;Ruben, ST;Hitchings, RA
目的：垂直杯盘比（CDR）长期以来被用于青光眼疑似患者的评估，尽管CDR值在正常人群中的广泛范围限制了它的使用。杯大小在生理上与椎间盘大小有关，在病理上与青光眼损伤有关。盘的大小可以在裂隙灯处测量为垂直盘直径（DD）。研究了CDR与DD鉴别青光眼视盘的能力。方法：对88例正常人、53例早期青光眼和59例高眼压患者进行立体视盘摄影和临床生物测量。用计算机辅助平面测量法对照片进行了蒙面分析。通过线性回归探讨了垂直杯径与DD之间的关系，并以CDR表示。正常的上限由该回归的95%预测区间（方法1）和CDR的97.5百分位数上限（方法2）定义。CDR鉴别青光眼视盘的敏感性和特异性通过小、中、大视盘的依赖和不依赖于视盘大小的切口进行测试。结果CDR与DD的关系为CDR = (-1.31 + (1.194 × DD))IDD。方法1对小、中、大圆盘的灵敏度分别为80%、60%、38%，方法2对小、中、大圆盘的灵敏度分别为33%、67%、63%。特异性分别为98.9%（方法1）和97.7%（方法2）。结论：相对于青光眼椎间盘大小，CDR在临床上是有用的，尤其是在鉴别青光眼小椎间盘方面。
Aims-The vertical cup/disc ratio (CDR) has long been used in the assessment of the glaucoma suspect, though the wide range of CDR values in the normal population limits its use. Cup size is related physiologically to disc size and pathologically to glaucomatous damage. Disc size can be measured at the slit lamp as the vertical disc diameter (DD). The ability of the CDR, in relation to DD, to identify glaucomatous optic discs was investigated.Methods-88 normal, 53 early glaucoma, and 59 ocular hypertensive subjects underwent stereoscopic optic disc photography and clinical biometry. Photographs were analysed in a masked fashion by computer assisted planimetry. The relation between vertical cup diameter and DD was explored by linear regression, and expressed in terms of CDR. The upper Limit of normal was defined by the 95% prediction intervals of this regression (method 1) and by the upper 97.5 percentile for CDR (method 2). The sensitivity and specificity of CDR to identify an optic disc as glaucomatous was tested with these disc size dependent and disc size independent cut offs in small, medium, and large discs.Results-The CDR was related to DD by the equation CDR = (-1.31 + (1.194 x DD))IDD. The sensitivity in small, medium, and large discs was 80%, 60%, and 38% respectively for method 1 and 33%, 67%, and 63% respectively for method 2. Specificity was 98.9% (method 1) and 97.7% (method 2).Conclusions-The CDR, relative to disc size, is useful clinically, especially to assist in identifying small glaucomatous discs.