目的:成人青光眼的中央诊断工具是乳头周围视网膜神经纤维层(pRNFL)的厚度。可以通过扫描激光偏振法(SLP)或光学相干断层扫描(OCT)进行评估。然而,调查儿童pRNFL测量值相关性的研究很少.这项研究旨在比较儿童人群中SLP和OCTpRNFL厚度测量的青光眼诊断能力。
方法:这项回顾性研究包括105名4-18岁的儿童(青光眼:22(21.0%);健康青光眼嫌疑人:83(79.0%)),用SLP检查(GDxPro/ECC,CarlZeissMeditec)和谱域OCT(SPECTRALIS®,海德堡工程公司)。在患病和健康参与者之间比较了pRNFL扇区的厚度。使用受试者操作特征曲线(AUC)和逻辑回归结果下的面积来比较SLP和OCT测量之间的青光眼辨别能力。
结果:使用OCT,pRNFL厚度下降的优越,鼻部,与健康对照组相比,青光眼患者的下象限(各P<0.001)。使用SLP,这种差异仅在下象限观察到(P=0.011)。青光眼诊断与OCT测量的pRNFL厚度之间的相关性在除时间以外的所有象限中发现(P<0.001)。使用SLP,总平均厚度(P=0.037)和下象限(P=0.0019)存在相关性.最后,OCT测量的AUC明显高于SLP(例如,下象限:OCT0.83,SLP0.68)。
结论:使用OCT和SLP进行pRNFL厚度测量,与青光眼的存在显著相关。总的来说,OCT的pRNFL厚度测量的诊断性能似乎高于SLP.因此,pRNFL厚度测量可以提供重要信息,在小儿青光眼的诊断过程中补充常规的临床和功能参数。
OBJECTIVE: A central diagnostic tool in adult glaucoma is the peripapillary retinal nerve fibre layer (pRNFL) thickness. It can be assessed by scanning laser polarimetry (SLP) or optical coherence tomography (OCT). However, studies investigating the relevance of pRNFL measurements in children are rare. This study aims to compare the glaucoma diagnosing ability of SLP and OCT pRNFL thickness measurements in a paediatric population.
METHODS: This retrospective study included 105 children (glaucoma: 22 (21.0%); healthy glaucoma suspects: 83 (79.0%)) aged 4-18 years, examined with SLP (GDxPro/ECC, Carl Zeiss Meditec) and spectral-domain OCT (SPECTRALIS®, Heidelberg Engineering). The thickness of pRNFL sectors was compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC) and logistic regression results were used to compare the glaucoma discriminative capacity between SLP and OCT measurements.
RESULTS: Using OCT, pRNFL thickness was decreased in the superior, nasal, and inferior quadrants of glaucoma patients compared to healthy controls (P < 0.001, each). With SLP, such a difference was only observed in the inferior quadrant (P = 0.011). A correlation between glaucoma diagnosis and OCT-measured pRNFL thickness was found in all quadrants (P < 0.001) other than the temporal. With SLP, a correlation was found for the total average thickness (P = 0.037) and inferior quadrant (P = 0.0019). Finally, the AUCs of OCT measurements were markedly higher than those of SLP (e.g., inferior quadrant: OCT 0.83, SLP 0.68).
CONCLUSIONS: pRNFL thickness measurements using both OCT and SLP, correlate notably with the presence of glaucoma. In general, the diagnostic performance of pRNFL thickness measurements seems higher for OCT than for SLP. Thus, pRNFL thickness measurements could provide important information, complementing conventional clinical and functional parameters in the diagnostic process of paediatric glaucoma.