StratusOCT诊断有视野缺损青光眼的敏感性及特异性

To determine the sensitivity and specificity of measurements of the retinal ne rve fiber layer (RNFL) using the StratusOCT in glaucoma subjects with visual fie ld (VF) defects. Prospective cross-sectional study. One hundred nine normal and 63 glaucoma subjects. Fast RNFL scans were performed in one eye of each patient using the StratusOCT. Sensitivity and specificity of different optical coherenc e tomography (OCT) criteria for identifying glaucoma subjects with glaucomatous VF defects. Areas under the receiver operating characteristic curves (AROCs) for various OCT parameters. Severity of VF defects in the glaucoma group was distri buted between mild (18 subjects), moderate (21 subjects), and severe (24 subject s). The average mean deviation of the glaucoma fields was-8.4 decibels (dB), wi th a standard deviation of 6.0 dB and a range from-0.14 to -28.0 dB. The sensi tivity and specificity using a criterion of average RNFL thickness abnormal at t he < 5%level were 84%and 98%, respectively. The sensitivity and specificity u sing a criterion of average RNFL thickness abnormal at the < 1%level were 68%a nd 100%. The sensitivity and specificity of using a criterion of ≥1 quadrants abnormal at the < 5%level were 89%and 95%. The sensitivity and specificity of using a criterion of ≥1 quadrants abnormal at the < 1%level were 83%and 100 %. The sensitivity and specificity of using a criterion of ≥1 clock hours abno rmal at the < 5%level were 89%and 92%. The sensitivity and specificity of usi ng a criterion of ≥1 quadrants abnormal at the < 1%level were 83%and 100%. T he AROC for mean RNFL thickness was 0.966. Other high AROC values included the s uperior quadrant (0.952), inferior quadrant (0.971), inferotemporal clock hour a t 7-o’clock (right eye) and 5-o’clock (left eye) (0.959), 6-o’clock hour ( 0.940), superotemporal clock hour at 11-o’clock (right eye) and 1-o’clock (l eft eye) (0.935), and 12-o’clock hour (0.924). The sensitivity and specificity of RNFL measurements using the new StratusOCT for glaucoma with manifest VF def ects are excellent. The best parameters seem to be ≥1 quadrants abnormal at the ≤5%level or ≥1 clock hours abnormal at the ≤5%level. Future studies are ne eded to determine the sensitivity and specificity of this new technology for gla ucoma without VF defects.

GDx VCCHRT—Ⅱ及Stratus OCT在青光眼诊断与随访中应用

目前，较成熟的视盘和视网膜神经纤维层成像技术已成为监测青光眼发生、发展的极具潜力的工具，临床上常用的包括GDx VCC、HRT—Ⅱ及Stratus OCT。这些仪器根据视网膜组织和光的不同特性，获得大量数字化的描述性信息，并将这些信息转化为图解报告，提供了客观、定量、重复性高的数据，且操作简便。国内外对其在青光眼筛查、诊断及随访中进行了大量的研究。