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The Relationship Between Retinal Nerve Fiber Layer Thickness and Optic Nerve Head Neuroretinal Rim Tissue in Glaucoma
摘要： PURPOSE. The purpose of this study was to determine the relationship between optical coherence tomography (OCT) measures of retinal nerve fiber layer (RNFL) and neuroretinal rim (NRR) in a nonhuman primate experimental glaucoma model, and in a population of clinical patients. METHODS. For nonhuman primates, normative data were collected from 44 healthy monkeys, and nine animals with unilateral experimental glaucoma that were followed longitudinally. Cross-sectional human subjects data were collected from 89 healthy, 74 glaucoma suspects, and 104 glaucoma patients. Individualized transverse scaling for OCT scans was calculated using a schematic eye that incorporated optical ocular biometry. Custom algorithms were used to quantify RNFL thickness with and without vessels removed, scaled minimum rim width (sMRW), and neural rim volume (NRV). RESULTS. For the experimental glaucoma group, NRR parameters showed the first changes with increased cumulative IOP. The data for both NRR and RNFL measures were best fit by an exponential rise model (NRV, R2 ? 0.79, P < 0.01, sMRW, R2 ? 0.74, P < 0.01). The major retinal vascular thickness contribution to the RNFL decreased (0.03 lm/lm, P < 0.01) with RNFL loss, but the percent vascular contribution increased ((cid:2)0.1%/lm, P < 0.01) with disease progression. Overall, the findings for the cross-sectional human data were similar to those of the experimental model. CONCLUSIONS. The findings illustrate a nonlinear relationship between NRR and RNFL measures and provide support for the use of multiple OCT scaled morphological measures for the diagnosis and management of primary open angle glaucoma in humans.
关键词： glaucoma,neuroretinal rim,RNFL,optical coherence tomography
更新于2025-09-19 17:15:36
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Diagnostic Accuracy of Glaucoma With Sector-Based and a New Total Profile–Based Analysis of Neuroretinal Rim and Retinal Nerve Fiber Layer Thickness
摘要： PURPOSE. To compare the diagnostic accuracy of conventional sector-based analysis with a method devised to detect the smallest localized neuroretinal rim and retinal nerve fiber layer thickness (RNFLT) damage. METHODS. One eye of 151 glaucoma patients and 83 healthy controls (median age and MD, 71.7 and 66.7 years, and (cid:2)3.6 and (cid:2)0.3 dB, respectively) was imaged with spectral-domain optical coherence tomography (OCT). Bruch’s membrane opening-minimum rim width (BMO-MRW) and RNFLT were determined at 18 intervals and also averaged for each sector. A classification of glaucoma was made with sectoral analysis when the sectoral value was below the 1%, 5%, or 10% normative limit (from an independent normative dataset); and with total analysis when a given number of measurements was below the 1%, 5%, or 10% normative limit. RESULTS. With the 1% normative limit, BMO-MRW sectoral analysis yielded sensitivity of 87% and specificity of 92%; while at the same specificity (92%), total analysis yielded sensitivity of 88%. With RNFLT, sectoral analysis yielded sensitivity of 85% and specificity of 95%; while at the same specificity (95%), total analysis yielded sensitivity of 83%. The results for the 5% and 10% normative limits yielded lower specificity but higher sensitivity. In the whole glaucoma population, none of the sensitivity values of the sectoral and total analysis at the same specificities were statistically different. CONCLUSIONS. The diagnostic accuracy of sectoral analysis was equivalent to total analysis. These results indicate that BMO-MRW and RNFLT defects were wide and deep enough for detection by conventional sectoral analysis.
关键词： diagnostic accuracy,neuroretinal rim,retinal nerve fiber layer
更新于2025-09-09 09:28:46
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Comprehensive Three-Dimensional Analysis of the Neuroretinal Rim in Glaucoma Using High-Density Spectral-Domain Optical Coherence Tomography Volume Scans
摘要： To describe spectral-domain optical coherence tomography (OCT) methods for quantifying neuroretinal rim tissue in glaucoma and to compare these methods to the traditional retinal nerve fiber layer thickness diagnostic parameter. Neuroretinal rim parameters derived from three-dimensional (3D) volume scans were compared with the two-dimensional (2D) Spectralis retinal nerve fiber layer (RNFL) thickness scans for diagnostic capability. This study analyzed one eye per patient of 104 glaucoma patients and 58 healthy subjects. The shortest distances between the cup surface and the OCT-based disc margin were automatically calculated to determine the thickness and area of the minimum distance band (MDB) neuroretinal rim parameter. Traditional 150-lm reference surface–based rim parameters (volume, area, and thickness) were also calculated. The diagnostic capabilities of these five parameters were compared with RNFL thickness using the area under the receiver operating characteristic (AUROC) curves. The MDB thickness had significantly higher diagnostic capability than the RNFL thickness in the nasal (0.913 vs. 0.818, P ? 0.004) and temporal (0.922 vs. 0.858, P ? 0.026) quadrants and the inferonasal (0.950 vs. 0.897, P ? 0.011) and superonasal (0.933 vs. 0.868, P ? 0.012) sectors. The MDB area and the three neuroretinal rim parameters based on the 150-lm reference surface had diagnostic capabilities similar to RNFL thickness. The 3D MDB thickness had a high diagnostic capability for glaucoma and may be of significant clinical utility. It had higher diagnostic capability than the RNFL thickness in the nasal and temporal quadrants and the inferonasal and superonasal sectors.
关键词： neuroretinal rim,spectral-domain optical coherence tomography,glaucoma,optic disc,optic nerve
更新于2025-09-04 15:30:14