光学相干断层成像术检测视网膜神经纤维层厚度的可重复性研究

Reproducibility of the measurement of peripapillary nerve fiber layer thickness by optical coherence tomography

探讨光学相干断层成像术检测正常人视网膜神经纤维层厚度的可重复性结果。方法 :采用双盲法 ,检查者甲、乙用光学相干断层成像术对 13例 ( 13眼 )正常人进行同样程序的检测 :以视乳头为中心 ,直径为 3 46mm圆周的视网膜神经纤维层厚度测量 ,连续测量 3天 ,每天每眼记录 5幅图象 ,取其中 3幅图象的视网膜神经纤维层厚度平均值为当天受检者的视网膜神经纤维层厚度值。计算 3天中全周平均及各象限视网膜神经纤维层厚度的标准差及变异系数。结果 :甲、乙组全周平均视网膜神经纤维层厚度的平均变异系数分别为 6 10± 3 15 %、 5 10± 3 2 3 % ,显示同一组内检测视网膜神经纤维层厚度可重复性好。甲、乙组鼻侧视网膜神经纤维层厚度均是重复性检测变异系数最大的象限 ( 9 75± 6 81%、10 15± 7 91% )。甲、乙组间重复性检测结果统计学上对比无显著差别 (P =0 65～ 0 95 ) ,说明不同操作者间的检测重复性好。所有 13眼甲、乙组间平均视网膜神经纤维层厚度对比无显著差异。结论 :光学相干断层成像术检测正常人全周及各象限视网膜神经纤维层厚度可重复性好。

Objective:To assess the Reproducibility of the measurement of retinal nerve fiber layer (RNFL) thickness by optical coherence tomography on normal eyes. 13 normal eyes were imaged by two operators.Five 360° circular scans with a diameter 3.46mm centered on the optic disc were obtained in each scanning, and 3 high-quality images in each day were picked up to form mean RNFL thickness.Images were obtained on three consecutive days.Variance and coefficient of variation were calculated for quadrantic retinal nerve fiber layer obtained from the mean image. Results:The means of CV for total RNFL thickness were 6.10±3.15% and 5.10±3.23% in two operators.The means of CV of nasal RNFL were 9.75±6.81%、10.15±7.91%.Interoperator reproducibility was good with statistically similar variance for all quadrantic retinal nerve fiber layer parameters (P=0.65～0.95)Differences in mean retinal nerve fiber layer thickness were not statistically significant between operators for all eyes. Conclusions:Peripapillary RNFL thickness using optical coherence tomography has good Intraoperator and Interoperator reproducibility.Nasal RNFL was the most variable sector.