AIM:To evaluate and compare structural optical coherence tomography(OCT)-based parameters,such as Bruch’s membrane opening-minimum rim width(BMO-MRW),and retinal nerve fiber layer(RNFL)thickness in glaucoma pa...AIM:To evaluate and compare structural optical coherence tomography(OCT)-based parameters,such as Bruch’s membrane opening-minimum rim width(BMO-MRW),and retinal nerve fiber layer(RNFL)thickness in glaucoma patients with visual field(VF)defects,and to correlate both to mean deviation(MD)values of obtained standard achromatic perimetry(SAP)examinations.METHODS:Patients with glaucoma and glaucomatous VF defects were enrolled in this prospective study and compared to age-matched healthy individuals.All study participants underwent a full ophthalmic examination and VF testing with SAP.Peripapillary RNFL thickness and BMO-MRW were acquired with SD-OCT.Correlation analyses between obtained global functional and global as well as sectorial structural parameters were calculated.RESULTS:A consecutive series of 30 glaucomatous right eyes of 30 patients were included and compared to 36healthy right eyes of 36 individuals in the control group.Global MD of values correlated significantly with global RNFL(Pearson corr.coeff:0.632,P=0.001)and global BMO-MRW(Pearson corr.coeff:0.746,P〈0.001)values in the glaucoma group.Global MD and sectorial RNFL or BMO-MRW values correlated less significantly.In the control group,MD values did not correlate with RNFL or BMO-MRW measurements.A subgroup analysis of myopic patients(〉4 diopters)within the glaucoma group(n=6)revealed a tendency for higher correlations between MD and BMO-MRW than MD and RNFL measurements.CONCLUSION:In a clinical setting,RNFL thickness and BMO-MRW correlate similarly with global VF sensitivity in glaucoma patients with BMO-MRW showing higher correlations in myopic glaucoma patients.展开更多
AIM:To determine the Bruch's membrane opening-minimum rim width(BMO-MRW) tipping point where corresponding visual field(VF) damages become detectable.METHODS:A total of 85 normal subjects and 83 glaucoma patie...AIM:To determine the Bruch's membrane opening-minimum rim width(BMO-MRW) tipping point where corresponding visual field(VF) damages become detectable.METHODS:A total of 85 normal subjects and 83 glaucoma patients(one eye per participant) were recruited for the study.All of the patients had VF examinations and spectral-domain optical coherence tomography to measure the BMO-MRW.Total deviation values for 52 VF points were allocated to the corresponding sector according to the Garway-Heath distribution map.To evaluate the relationship between VF loss and BMOMRW measurements,a "broken-stick" statistical model was used.The tipping point where the VF values started to sharply decrease as a function of BMO-MRW measurements was estimated and the slopes above and below this tipping point were compared.RESULTS:A 25.9% global BMO-MRW loss from normative value was required for the VF loss to be detectable.Sectorally,substantial BMO-MRW thinning in inferotemporal sector(33.1%) and relatively less BMO-MRW thinning in the superotemporal sector(8.9%) were necessary for the detection of the VF loss.Beyond the tipping point,the slopes were close to zero throughout all of the sectors and the VF loss was unrelated to the BMO-MRW loss.The VF loss was related to the BMO-MRW loss below the tipping point.The difference between the two slopes was statistically significant(P≤0.002).CONCLUSION:Substantial BMO-MRW loss appears to be necessary for VF loss to be detectable in patients with open angle glaucoma with standard achromatic perimetry.展开更多
AIM: To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography(OCT) in normal, preperimetric glaucoma(PPG) and perimetric glaucoma(PG) patients. METHODS: This cross-sectiona...AIM: To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography(OCT) in normal, preperimetric glaucoma(PPG) and perimetric glaucoma(PG) patients. METHODS: This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG(51 eyes), PG(46 eyes), and normal controls(30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer(RNFL) and Bruch’s membrane opening-minimum rim width(BMO-MRW) to assess the optic nerve head and ganglion cell layer(GCL) thickness in the macula. RESULTS: RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity(>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves(AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW(AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively).CONCLUSION: While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.展开更多
文摘AIM:To evaluate and compare structural optical coherence tomography(OCT)-based parameters,such as Bruch’s membrane opening-minimum rim width(BMO-MRW),and retinal nerve fiber layer(RNFL)thickness in glaucoma patients with visual field(VF)defects,and to correlate both to mean deviation(MD)values of obtained standard achromatic perimetry(SAP)examinations.METHODS:Patients with glaucoma and glaucomatous VF defects were enrolled in this prospective study and compared to age-matched healthy individuals.All study participants underwent a full ophthalmic examination and VF testing with SAP.Peripapillary RNFL thickness and BMO-MRW were acquired with SD-OCT.Correlation analyses between obtained global functional and global as well as sectorial structural parameters were calculated.RESULTS:A consecutive series of 30 glaucomatous right eyes of 30 patients were included and compared to 36healthy right eyes of 36 individuals in the control group.Global MD of values correlated significantly with global RNFL(Pearson corr.coeff:0.632,P=0.001)and global BMO-MRW(Pearson corr.coeff:0.746,P〈0.001)values in the glaucoma group.Global MD and sectorial RNFL or BMO-MRW values correlated less significantly.In the control group,MD values did not correlate with RNFL or BMO-MRW measurements.A subgroup analysis of myopic patients(〉4 diopters)within the glaucoma group(n=6)revealed a tendency for higher correlations between MD and BMO-MRW than MD and RNFL measurements.CONCLUSION:In a clinical setting,RNFL thickness and BMO-MRW correlate similarly with global VF sensitivity in glaucoma patients with BMO-MRW showing higher correlations in myopic glaucoma patients.
文摘AIM:To determine the Bruch's membrane opening-minimum rim width(BMO-MRW) tipping point where corresponding visual field(VF) damages become detectable.METHODS:A total of 85 normal subjects and 83 glaucoma patients(one eye per participant) were recruited for the study.All of the patients had VF examinations and spectral-domain optical coherence tomography to measure the BMO-MRW.Total deviation values for 52 VF points were allocated to the corresponding sector according to the Garway-Heath distribution map.To evaluate the relationship between VF loss and BMOMRW measurements,a "broken-stick" statistical model was used.The tipping point where the VF values started to sharply decrease as a function of BMO-MRW measurements was estimated and the slopes above and below this tipping point were compared.RESULTS:A 25.9% global BMO-MRW loss from normative value was required for the VF loss to be detectable.Sectorally,substantial BMO-MRW thinning in inferotemporal sector(33.1%) and relatively less BMO-MRW thinning in the superotemporal sector(8.9%) were necessary for the detection of the VF loss.Beyond the tipping point,the slopes were close to zero throughout all of the sectors and the VF loss was unrelated to the BMO-MRW loss.The VF loss was related to the BMO-MRW loss below the tipping point.The difference between the two slopes was statistically significant(P≤0.002).CONCLUSION:Substantial BMO-MRW loss appears to be necessary for VF loss to be detectable in patients with open angle glaucoma with standard achromatic perimetry.
基金Supported by Norshamsiah Md Din receives funding from the UKMMC Fundamental Research Grant (No.FF-2017-169)Yusof AMZ receives a Masters scholarship funded by the Government of Malaysia。
文摘AIM: To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography(OCT) in normal, preperimetric glaucoma(PPG) and perimetric glaucoma(PG) patients. METHODS: This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG(51 eyes), PG(46 eyes), and normal controls(30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer(RNFL) and Bruch’s membrane opening-minimum rim width(BMO-MRW) to assess the optic nerve head and ganglion cell layer(GCL) thickness in the macula. RESULTS: RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity(>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves(AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW(AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively).CONCLUSION: While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.