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Abstract：
OBJECTIVE: To compare the performance of Moorfields Regression Analysis (MRA) and optical coherence tomography (OCT) with that of photographic evaluation of the optic nerve head and retinal nerve fiber layer (RNFL) in the application of the Finnish Evidence-Based Guideline for Open-Angle Glaucoma (FEBG-OAG).
METHODS: Patients referred for glaucoma evaluation (n=312) and subjects selected from the general population (n=41) were included in the study. All subjects underwent ophthalmic evaluation, optic nerve head stereophotography, monochromatic RNFL photography, Heidelberg retina tomography, OCT, and laser polarimetry evaluation. The subjects were classified based on stereophotographic or MRA and OCT results by applying the FEBG-OAG.
RESULTS: The specificity of the FEBG-OAG for detecting normal patients (stereophotography and imaging devices) was 78% (strict criteria) and 100% (liberal criteria). Agreement between the stereophotographic evaluation and evaluation based on MRA and OCT was 70.2%. Classification of subjects with similar management advice based on these evaluations had 70.5% agreement. Central corneal thickness was a confounding factor in glaucoma diagnosis. Large optic disc sizes played a major role in misleading the diagnosis compared to small discs.
CONCLUSIONS: Central corneal thickness and large optic disc size are confounding factors in glaucoma diagnosis. Moorfields Regression Analysis and OCT allow for objective implementation of the FEBG-OAG compared to conventional stereophotographic evaluation of the neuroretinal structures.
METHODS: Patients referred for glaucoma evaluation (n=312) and subjects selected from the general population (n=41) were included in the study. All subjects underwent ophthalmic evaluation, optic nerve head stereophotography, monochromatic RNFL photography, Heidelberg retina tomography, OCT, and laser polarimetry evaluation. The subjects were classified based on stereophotographic or MRA and OCT results by applying the FEBG-OAG.
RESULTS: The specificity of the FEBG-OAG for detecting normal patients (stereophotography and imaging devices) was 78% (strict criteria) and 100% (liberal criteria). Agreement between the stereophotographic evaluation and evaluation based on MRA and OCT was 70.2%. Classification of subjects with similar management advice based on these evaluations had 70.5% agreement. Central corneal thickness was a confounding factor in glaucoma diagnosis. Large optic disc sizes played a major role in misleading the diagnosis compared to small discs.
CONCLUSIONS: Central corneal thickness and large optic disc size are confounding factors in glaucoma diagnosis. Moorfields Regression Analysis and OCT allow for objective implementation of the FEBG-OAG compared to conventional stereophotographic evaluation of the neuroretinal structures.
摘要：
目的：比较Moorfields回归分析（MRA）和光学相干断层扫描（OCT）与视神经乳头和视网膜神经纤维层（RNFL）的照相评估在芬兰基于证据的开角型青光眼指南（FEBG-OAG）中的应用。
方法：将接受青光眼评估的患者（n=312）和从普通人群中选择的受试者（n=41）纳入研究。所有受试者都接受了眼科评估，视神经头立体摄影,单色RNFL摄影，海德堡视网膜断层扫描，OCT,和激光偏振评估。通过应用FEBG-OAG，根据立体摄影或MRA和OCT结果对受试者进行分类。
结果：FEBG-OAG用于检测正常患者（立体摄影和成像设备）的特异性为78％（严格标准）和100％（自由标准）。立体摄影评价与基于MRA和OCT的评价之间的一致性为70.2%。基于这些评估，具有类似管理建议的受试者的分类具有70.5％的一致性。中央角膜厚度是青光眼诊断的混杂因素。与小椎间盘相比，大视盘大小在误导诊断中起着重要作用。
结论：中央角膜厚度和大的视盘大小是青光眼诊断的混杂因素。与神经视网膜结构的常规立体摄影评估相比，Moorfields回归分析和OCT允许FEBG-OAG的客观实施。
方法：将接受青光眼评估的患者（n=312）和从普通人群中选择的受试者（n=41）纳入研究。所有受试者都接受了眼科评估，视神经头立体摄影,单色RNFL摄影，海德堡视网膜断层扫描，OCT,和激光偏振评估。通过应用FEBG-OAG，根据立体摄影或MRA和OCT结果对受试者进行分类。
结果：FEBG-OAG用于检测正常患者（立体摄影和成像设备）的特异性为78％（严格标准）和100％（自由标准）。立体摄影评价与基于MRA和OCT的评价之间的一致性为70.2%。基于这些评估，具有类似管理建议的受试者的分类具有70.5％的一致性。中央角膜厚度是青光眼诊断的混杂因素。与小椎间盘相比，大视盘大小在误导诊断中起着重要作用。
结论：中央角膜厚度和大的视盘大小是青光眼诊断的混杂因素。与神经视网膜结构的常规立体摄影评估相比，Moorfields回归分析和OCT允许FEBG-OAG的客观实施。
