关键词: 频域相干光断层扫描, 青光眼/诊断, 视网膜神经节细胞复合体

Abstract: 【Abstract】 Objective To evaluate the diagnostic value of retinal ganglion cell complex (GCC) thickness in open angle glaucoma by comparing with peripapillary retinal nerve fiber layer thickness(pRNFL) and their combinations. Design Diagnostic method evaluation. Participants 66 patients with primary open angle glaucoma (POAG) and 40 healthy controls who came to yelegesenteret during October 2013 to March 2014 were included in this study. According to the Hodapp-Anderson-Parrish (HAP) grading scale, POAG patients were classified into two subgroups, which were an early group (EG) and a moderate-to-advanced group (AG). By HAP criteria, 34 eyes were included in EG, whereas 32 eyes were in AG. Methods All subjects underwent SD-OCT (iVue 100) imaging: GCC parameters and ONH parameters were measured in each participant. By comparing the area under the receiver operator characteristic curves, the diagnostic abilities of the parameters were evaluated. Main Outcome Measures Thickness of GCC and pRNFL. Results The total GCC thickness showed strong correlation with corresponding pRNFL. Both the total thickness of GCC (EG 81.03±6.37 μm, AG 76.28±9.39 μm) and corresponding pRNFL (EG 80.47± 9.02 μm, AG 69.84± 11.74 μm)  appeared significant reduction in glaucoma group comparing with the normal group (GCC 92.90±6.07 μm, pRNFL 96.98 ± 8.09 μm). The parameter with the best diagnostic ability in EG compared with in normal subjects after adjusting age was the superior GCC thickness (AUC=0.929). The parameter with the best diagnostic ability in AG compared with in normal subjects after adjusting age was the total pRNFL thickness (AUC=0.988). In EG, the combination of total GCC thickness and total pRNFL thickness by statistical regressive method may improve diagnostic ability, but without statistical significance. In AG, the parallel combination of total GCC thickness and total pRNFL thickness may significantly improve sensitivity by comparing with sole total pRNFL thickness. Conclusions Imaging of GCC using SD-OCT (iVue 100) has strong diagnostic ability and was comparable to pRNFL measurement in distinguishing POAG patients from healthy subjects irrespective the severity of POAG. The parallel combination of these two parameters may improve sensitivity in AG. (Ophthalmol CHN, 2015, 24: 26-30, 35)

Key words: spectral-domain optical coherence tomography, glaucoma/diagnosis, ganglion cell complex