- 作者：Kouros Nouri-Mahdavi ; Sara Nowroozizadeh ; Nariman Nassiri ; Nila Cirineo ; Shane Knipping ; Joann Giaconi ; Joseph Caprioli
- 刊名：American Journal of Ophthalmology
- 出版年：December, 2013
- 年：2013
- 卷：156
- 期：6
- 页码：1297-1307.e2
- 全文大小：950 K
Purpose
To evaluate the performance of ganglion cell layer/inner plexiform layer (GCL/IPL) measurements with spectral-domain optical coherence tomography (Cirrus HD-OCT) for detection of early glaucoma and to compare results to retinal nerve fiber layer (RNFL) measurements.Design
Cross-sectional prospective diagnostic study.
Methods
We enrolled 99 subjects, including 59 eyes with glaucoma (47 subjects) (mean deviation >鈭?.0 dB) and 91 normal eyes (52 subjects). Patients underwent biometry and peripapillary and macular OCT imaging. Performance of the GCL/IPL and RNFL algorithms was evaluated with area under receiver operating characteristic curves (AUC), likelihood ratios, and sensitivities/specificities adjusting for covariates. Combination of best parameters was explored.
Results
Average (SD) mean deviation in the glaucoma group was聽鈭?.5 (1.9) dB. On multivariate analyses, age (P < 0.001) and axial length (P聽= 0.03) predicted GC/IPL measurements in normal subjects. No significant correlation was found between average or regional GC/IPL thickness and respective outer retina (OR) thickness measurements (P > 0.05). Average RNFL thickness performed better than average GCL/IPL measurements for detection of glaucoma (AUC聽= 0.964 vs 0.937; P聽= 0.04). The best regional measures from each algorithm (inferior quadrant RNFL vs minimum GCL/IPL) had comparable performances (P聽= 0.78). Entering the GC/IPL to OR ratio into prediction models did not enhance the performance of the GCL/IPL measures. Combining the best parameters from each algorithm improved detection of glaucoma (P聽= 0.04).
Conclusions
Regional GCL/IPL measures derived from Cirrus HD-OCT performed as well as regional RNFL outcomes for detection of early glaucoma. Using the GC/IPL to OR ratio did not enhance the performance of GCL/IPL parameters. Combining the best measures from the 2 algorithms improved detection of glaucoma.