Peripapillary choroidal thickness in glaucoma measured with optical coherence tomography
Peripapillary choroidal thickness in glaucoma measured with optical coherence tomography
复制标题
DOI：
10.1016/j.exer.2011.01.002
复制
发表时间：
2011-03-01
影响因子：
3.4
通讯作者：
Radcliffe, Nathan M.
中科院分区：
文献类型：
--
作者：
Ehrlich, Joshua R.;Peterson, Jeffrey;Radcliffe, Nathan M.
由于青光眼有脉络膜改变，我们使用光谱域光学相干断层扫描（SD-OCT）检查了原发性开角型青光眼（POAG）患者和非原发性开角型青光眼患者的乳头周围脉络膜厚度（CT）。我们对70例患者的70只眼进行SD-OCT回顾性测量。POAG （n = 31）和可疑眼（n = 39）分别有两个可靠且可重复的Humphrey 24-2视野，青光眼半视野测试在正常范围外或正常范围内。采用视网膜神经纤维层（RNFL）评估的标准方案进行360度乳头周围扫描。使用提供的软件，两个独立的蒙面调查员手动分割CT作为可见脉络膜血管的区域。采用Lin’s一致性相关系数（CCC）来确定调查者之间的一致性。单个蒙面观察者测定每个视神经象限的乳头旁萎缩（PPA）和β PPA的存在。评估RNFL与CT的相关性；采用双样本t检验确定POAG与疑似眼的RNFL和CT差异；采用线性回归模拟RNFL和CT的变化。我们发现两个观察者对CT的独立测量高度相关（Lin’s CCC for global CT; rho(c) = 0.93, p < 0.001）。RNFL与CT测量在任何乳头周围位置均无显著相关性（竖条r = 0.22）。整体CT （β = -1.94,95%可信区间[CI] -2.76, -1.13）但RNFL厚度（β = -0.18, 95% Cl -0.58, 0.22）随年龄的增长而显著下降。与怀疑的眼睛相比，POAG的眼睛在所有位置的RNFL测量值都显着变薄（p = 0.13）。调整青光眼状态和年龄后，PPA的总时间（β = 3.15 95% Cl -0.24, 6.53）和β时钟时间（β = 1.33, 95% Cl -1.72, 4.38）与全局CT无显著相关性；PPA的空间分布与基础CT无关，尽管PPA是主观分级的，并且可能与SD-OCT上单一的乳头周围偏心率在空间上不匹配。我们得出结论，POAG的眼睛没有表现出CT降低，RNFL和CT图之间也没有相关性。本研究不支持使用CT评估青光眼的诊断和治疗。(C) 2011 Elsevier Ltd.版权所有。
As choroidal changes have been suggested in glaucoma, we examined peripapillary choroidal thickness (CT) in patients with and without primary open-angle glaucoma (POAG) using spectral-domain optical coherence tomography (SD-OCT). We collected measurements retrospectively on 70 eyes of 70 patients consecutively undergoing SD-OCT. POAG (n = 31) and suspect eyes (n = 39) had two reliable and repeatable Humphrey 24-2 visual fields with glaucoma hemifield test outside or within normal limits, respectively. A 360-degree peripapillary scan was performed using the standard protocol for retinal nerve fiber layer (RNFL) assessment. Using provided software, two independent masked investigators manually segmented CT as the area of visible choroidal vasculature. Agreement between investigators was determined using Lin's concordance correlation coefficient (CCC). A single masked observer determined clock hours of parapapillary atrophy (PPA) and the presence of beta PPA for each optic nerve quadrant. Correlation between RNFL and CT was assessed; two-sample t-tests were used to determine differences in RNFL and CT between POAG and suspect eyes; and linear regression was used to model changes in RNFL and CT. We found that independent measurements of CT by two observers were highly correlated (Lin's CCC for global CT; rho(c) = 0.93, p < 0.001). RNFL and CT measurements were not significantly correlated for any peripapillary location (vertical bar r vertical bar = 0.22). Global CT (beta = -1.94,95% confidence interval [CI] -2.76, -1.13) but not RNFL thickness (beta = -0.18, 95% Cl -0.58, 0.22) decreased significantly with age. Compared to suspect eyes, eyes with POAG had significantly thinner RNFL measurements at all locations (p = 0.13). Adjusting for glaucoma status and age, total (beta = 3.15 95% Cl -0.24, 6.53) and beta clock hours of PPA (beta = 1.33, 95% Cl -1.72, 4.38) were not significantly associated with global CT; the spatial distribution of PPA was not associated with underlying CT, though PPA was graded subjectively and may have been subject to spatial mismatch with a singular peripapillary eccentricity on SD-OCT. We conclude that eyes with POAG did not demonstrate reduced CT nor was there a correlation between RNFL and CT maps. This study does not support the use of CT assessment in glaucoma diagnosis or management. (C) 2011 Elsevier Ltd. All rights reserved.