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采用光学相干断层扫描术扫描乳头周围三维视网膜神经纤维层体积来诊断青光眼

Khoueir, Z., Jassim, F., Poon, L.Y., et al.

期刊名称:American journal of ophthalmology

卷期:2017年第182卷

摘要

摘要:目的:旨在确定光学相干断层扫描术扫描(OCT)视乳头周围三维视网膜神经纤维层(RNFL)体积对开角型青光眼(OAG)的诊断能力。设计:诊断准确度评估。方法:地点:学术临床点。研究人群:共180例(113OAG67例正常受试者)。观察步骤:对每个受试者的一只眼进行研究。使用4个不同大小的annuli计算全眼,象限和扇区的视乳头周围 3D RNFL体积。还进行了视乳头周围2D RNFL厚度扫描。主要观察指标:受试者工作特征曲线下面积(AUROC)值,灵敏度,特异性,阳性和阴性预测值,阳性和阴性似然比。结果:在所有2D3D RNFL参数中,最佳诊断能力与最小annulus的下象限3D RNFL体积(AUROC0.977)相关。全眼3D RNFL体积AUROC值与所有4个尺寸annulus的全眼2D RNFL厚度AUROC值相当(P值:0.05930.6866)。当比较全眼RNFL体积的4annulus尺寸时,最小annuliAUROC值最佳(P值:0.03170.0380)。最小尺寸的annulus可能具有最好的诊断潜力,部分原因是没有排除大于6×6 mm2)扫描区域。结论:视乳头周围 3D RNFL体积检测青光眼时显示出良好的诊断性能。尽管差异无统计学意义,但与视乳头周围 2D RNFL厚度测量相比,视乳头周围3D RNFL体积参数具有相同或更好的诊断能力。

PURPOSE:To determine the diagnostic capability of peripapillary 3-dimensional (3D) retinal nerve fiber layer (RNFL) volume measurements from spectral-domain optical coherence tomography (OCT) volume scans for open-angle glaucoma (OAG).DESIGN:Assessment of diagnostic accuracy.METHODS:Setting: Academic clinical setting.STUDY POPULATION:Total of 180 patients (113 OAG and 67 normal subjects).OBSERVATION PROCEDURES:One eye per subject was included. Peripapillary 3D RNFL volumes were calculated for global, quadrant, and sector regions, using 4 different-size annuli. Peripapillary 2D RNFL thickness circle scans were also obtained.MAIN OUTCOME MEASURES:Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios.RESULTS:Among all 2D and 3D RNFL parameters, best diagnostic capability was associated with inferior quadrant 3D RNFL volume of the smallest annulus (AUROC value 0.977). Otherwise, global 3D RNFL volume AUROC values were comparable to global 2D RNFL thickness AUROC values for all 4 annulus sizes (P values: .0593 to .6866). When comparing the 4 annulus sizes for global RNFL volume, the smallest annulus had the best AUROC values (P values: .0317 to .0380). The smallest-size annulus may have the best diagnostic potential, partly owing to having no areas excluded for being larger than the 6 × 6 mm(2) scanned region.CONCLUSION:Peripapillary 3D RNFL volume showed excellent diagnostic performance for detecting glaucoma. Peripapillary 3D RNFL volume parameters have the same or better diagnostic capability compared to peripapillary 2D RNFL thickness measurements, although differences were not statistically significant.


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