关键词: 神经节细胞-内丛状层, 相干光断层扫描, 青光眼, 不对称性分析

Abstract:

 Objective To investigate the diagnostic value of asymmetry parameters in retina and macular posterior pole in early primary open angle glaucoma (POAG). Design Diagnostic technique evaluation. Participants 50 eyes of 100 patients with early POAG and 100 eyes of 50 cases in normal control. Methods All eyes underwent Cirrus HD-OCT for thickness of total, inferior, superior retinal nerve fiber layer (RNFL) around the optic disc、macular and ganglion cell-inner plexiform layer (GCIPL), and then calculated intereye and intraeye difference (posterior pole asymmetry parameters analysis). The mean field defect (MD) and pattern standard deviation (PSD) were recorded using a Humphrey perimeter. The area under the curve (AUC) was used to evaluate the ability of the parameters to diagnose early POAG. Main Outcome Measures RNFL thickness, macular thickness and GCIPL thickness of two groups, asymmetric analysis for intereye and intraeye difference of RNFL thickness, macular thickness and GCIPL thickness. The AUC value of each parameter, the sensitivity of the fixed specificity.  Results The RNFL thickness, macular thickness and GCIPL thickness in the early POAG group were significantly thinner than those in the normal control group (P<0.05). In addition to the difference in the intraocular RNFL thickness (P=0.128), there were significant difference (P<0.05) in the absolute difference between the two groups in the asymmetry of other measurement parameters. The highest GCIPL diagnostic efficacy was the intereye difference of the superior GCIPL thickness , AUC was 0.933, followed by the total GCIPL thickness (AUC=0.922). The highest RNFL around the optic disc diagnostic efficacy is intereye difference of the total RNFL thickness (AUC=0.894). The highest macular diagnostic efficacy was total macular thickness (AUC=0.85). The sensitivity of total GCIPL thickness was the highest, with a 95% specificity of 85%, followed by intereye total GCIPL thickness difference of 80%. Conclusion The diagnostic value of RNFL thickness around optic disc and GCIPL thickness, especially their intereye asymmetric parameters respectively were worth more than macular thickness in early diagnosis of POAG measured by Cirrus-HD OCT. But the analysis of intraocular asymmetric parameters showed the lowest diagnostic ability and the lowest AUC. (Ophthalmology, 2018, 27: 26-30)

Key words: macular and ganglion cell-inner plexiform layer, optical coherence tomography, glaucoma, asymmetric analysis