Stratus OCT与GDxVCC测量正常人与青光眼患者视网膜神经纤维层厚度比较研究

Comparison of Stratus OCT and GDxVCC on the Retinal Nerve Fiber Layer Measurement of Normal and Glaucomatous Eyes

目的 比较相干光断层扫描仪StratusOCT与激光偏振光视网膜扫描仪GDxVCC测量视网膜神经纤维层（RNFL）厚度的相关性及差异,探讨两者测量值与视野的相关性及其对青光眼的诊断效能.方法 84例原发性开角型青光眼（POAG）患者及50名正常人,随机选取一眼进行StratusOCT和GDxVCCRNFL厚度测量及Humphery自动视野计检查.相关分析比较两种仪器测量的全周、上方、下方RNFL厚度;回归分析研究视野的平均偏差与两种仪器测量的RNFL厚度值之间的关系;ROC曲线下面积分析两种仪器诊断青光眼的效能.结果 Stratus OCT测量正常人及POAG患者的全周RNFL厚度分别为（100.00±7.36）μm和（75.12±17.11）μm,GDxVCC对应测量值（57.16±5.05）μm和（48.00.4±8.46）μm.两种仪器测量的RNFL厚度呈线性相关（r〉0.75）.两种仪器测量的RNFL厚度值与视野的平均偏差呈正相关,三次曲线拟合度较直线相关的拟合度好.对于青光眼诊断,Stratus OCT的最大ROC曲线下面积为0.908,GDxVCC最大ROC曲线下面积为0.842.结论 Stratus OCT与GDxVCC测量RNFL厚度值存在差异,但两者呈线性相关,均与视野的平均偏差呈曲线相关.两种仪器诊断青光眼的效能均较好.

Objective To compare the measurement of RNFL thickness by Stratus OCT and GDxVCC and their relationships with visual field. Methods Eighty-four patients with open-angle glaucoma and 50 normal subjects were included in this cross-sectional study. Stratus OCT and GDxVCC measurement of RNFL thickness and standard automated perimetry were performed. The global, superior and inferior RNFL thickness measurement between Stratus OCT and GDxVCC were compared. The relationship of mean deviation （MD） of visual field and RNFL thickness by Stratus OCT and GDxVCC were evaluated by regression analysis. The diagnostic performances of both instruments were analyzed using receptor operation character （ROC） curves. Results The global RNFL thicknesses of normal eyes were 100.00± 7.36μ m as measured by Stratus OCT and 57.16± 5.05 μ m by GDxVCC, whereas those of glaucomatous eyes were 75.12± 17.11 μ m by Stratus OCT and 48.00± 8.46 μ m by GDxVCC. Significant linear correlations were shown between RNFL thicknesses measured by Stratus OCT and GDxVCC （r〉0.75）. When MD was plotted against RNFL thickness, curvilinear regression model fits better than linear regression one. The largest area under ROC curve （AUC） by Stratus OCT was global RNFL thickness （AUC=0.908）, while that of GDxVCC was inferior RNFL thickness （AUC=0.842）. Conclusions Although there are difference between the RNFL values measured by Stratus OCT and GDxVCC, they correlate significantly. The RNFL thicknesses measured by both instruments showed a good curvilinear correlation with MD. The diagnostic performances of RNFL measurements by both Stratus OCT and GDxVCC are preferably.