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光学相干断层扫描青光眼进展和视野比较

Zhang, X., Dastiridou, A., Francis, B.A., et al.

期刊名称:American journal of ophthalmology

卷期:2017年第184卷

摘要

摘要:目的:旨在使用光学相干断层扫描(OCT)和视野(VF)对纵向青光眼进展检测进行比较。设计:有效性评估。方法:我们分析了多中心高级成像青光眼研究中4次以上半年随访(每6个月)的患者。使用傅里叶域光学相干断层扫描(OCT)绘制周围视网膜神经纤维层(NFL)和神经节细胞复合体(GCC)厚度。OCT进展检测定义为NFLGCC显着负向趋势。如果事件或趋势分析达到显着性,则达到VF进展。结果:分析包括356只青光眼疑似/前期青光眼(GS / PPG)眼和153只眼视野计青光眼(PG)。 GS / PPG眼的随访时间为54.1±16.2个月,PG眼的随访时间为56.7±16.0个月。 OCT检查发现,62.1%的PG眼出现进展,59.8%的GS / PPG眼出现进展,检出率明显高于VF检出率41.8%和27.3%(P <0.001)。在PG眼严重分层分析中,OCT在轻度PG中检出率明显高于VF63.1%:38.7%,P <0.001),但在中度和晚期PG中检出率则无上述结果。晚期PGNFL减薄率显着减慢,但GCC减薄率仍保持相对稳定,即使在晚期疾病中也能检测到良好的进展。 Kaplan-Meier时间 - 事件分析显示,OCT检测到的PGGS / PPG进展早于VF。结论:用于检测早期青光眼进展时,OCTVF更敏感。虽然NFL的功效在晚期青光眼中下降,但GCC仍然是一种从早期到晚期敏感的进展检测指标。

PURPOSE:To compare longitudinal glaucoma progression detection using optical coherence tomography (OCT) and visual field (VF).DESIGN:Validity assessment.METHODS:We analyzed subjects with more than 4semi-annual follow-up visits (every 6months) in the multicenter Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of the peripapillary retinal nerve fiber layer (NFL) and ganglion cell complex (GCC). OCT-based progression detection was defined as a significant negative trend for either NFL or GCC. VF progression was reached if either the event or trend analysis reached significance.RESULTS:The analysis included 356 glaucoma suspect/preperimetric glaucoma (GS/PPG) eyes and 153 perimetric glaucoma (PG) eyes. Follow-up length was 54.1 ± 16.2 months for GS/PPG eyes and 56.7 ± 16.0 for PG eyes. Progression was detected in 62.1% of PG eyes and 59.8% of GS/PPG eyes by OCT, significantly (P< .001) more than the detection rate of 41.8% and 27.3% by VF. In severity-stratified analysis of PG eyes, OCT had significantly higher detection rate than VF in mild PG (63.1% vs. 38.7%, P < .001), but not in moderate and advanced PG. The rate of NFL thinning slowed dramatically in advanced PG, but GCC thinning rate remained relatively steady and allowed good progression detection even in advanced disease. The Kaplan-Meier time-to-event analyses showed that OCT detected progression earlier than VF in both PG and GS/PPG groups.CONCLUSIONS:OCT is more sensitive than VF for the detection of progression in early glaucoma. While the utility of NFL declines in advanced glaucoma, GCC remains a sensitive progression detector from early to advanced stages.


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