研究目的
To compare the effectiveness of detecting progressive retinal nerve fiber layer (RNFL) thickness changes using widefield scans compared to circumpapillary circle scans derived from optic disc volume scans when using a manual region-of-interest (ROI) approach.
研究成果
Progressive RNFL thickness changes were more effectively detected on widefield OCT scans using a manual ROI approach compared to conventional derived circumpapillary circle scans, highlighting the potential advantages of widefield scans for monitoring glaucomatous progression.
研究不足
Age-related change estimates were cross-sectional rather than longitudinal; measurement variability estimates were from intrasession data rather than short-term between-session data; progressive changes were evaluated over only two visits and a relatively short duration; generalizability of the manual ROI approach requires further intra- and intergrader assessments.
1：Experimental Design and Method Selection:
A prospective longitudinal observational study was conducted to compare three methods for detecting progressive RNFL changes: global circumpapillary RNFL thickness (cpRNFLG), average cpRNFL thickness in a manually outlined ROI from optic disc scans (cpRNFLROI), and average RNFL thickness in a manually outlined ROI from widefield scans (wfRNFLROI). Longitudinal signal-to-noise ratios (SNRs) were used as the primary outcome measure, normalizing the rate of change by individualized estimates of measurement variability and age-related change.
2：Sample Selection and Data Sources:
Participants included healthy individuals and those with glaucoma or suspected glaucoma. Eyes were required to have reliable visual field tests and OCT scans. The longitudinal group consisted of 125 eyes with scans at least one year apart; variability groups for test-retest estimates included 284 eyes for widefield scans and 321 eyes for optic disc scans; normative groups for age-related changes included 418 eyes for widefield scans and 394 eyes for optic disc scans.
3：List of Experimental Equipment and Materials:
Swept-source OCT device (Atlantis DRI OCT-1; Topcon, Inc.) for widefield scans, spectral-domain OCT device (3D OCT-2000; Topcon, Inc.) for optic disc scans, visual field analyzer (Humphrey Field Analyzer II-I; Carl Zeiss Meditec, Inc.), MATLAB software (MathWorks) for data analysis, and Stata software (StataCorp LP) for statistical analysis.
4：Experimental Procedures and Operational Workflow:
OCT scans were obtained and manually coregistered. ROIs were manually outlined based on review of scan features. RNFL thickness changes were calculated between visits, and longitudinal SNRs were derived using estimates from variability and normative groups.
5：Data Analysis Methods:
Linear mixed models were used for statistical comparisons, accounting for hierarchical data structure. Longitudinal SNRs were calculated as (rate of change - age-related change) / measurement variability.
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