[1]彭红娟,方林彬,郑彪.基于频域光学相干断层扫描（SD-OCT）的视盘周围视网膜总厚度在早期视盘水肿诊断中的应用[J].眼科新进展,2020,40(1):042-45.[doi:10.13389/j.cnki.rao.2020.0010]
　PENG Hongjuan,FANG Linbin,ZHENG Biao.Role of circumpapillary total retinal thickness measured with SD-OCT in diagnosis of early stage optic disc edema[J].Recent Advances in Ophthalmology,2020,40(1):042-45.[doi:10.13389/j.cnki.rao.2020.0010]
点击复制

基于频域光学相干断层扫描（SD-OCT）的视盘周围视网膜总厚度在早期视盘水肿诊断中的应用/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年1期
页码:
042-45
栏目:
应用研究
出版日期:
2020-01-05

文章信息/Info

Title:
Role of circumpapillary total retinal thickness measured with SD-OCT in diagnosis of early stage optic disc edema
文章编号:
20200110
作者:
彭红娟; 方林彬; 郑彪
524001　广东省湛江市，广东医科大学附属医院眼科
Author(s):
PENG Hongjuan; FANG Linbin; ZHENG Biao
Department of Ophthalmology,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong Province,China
Corresponding author:FANG Linbin,E-mail：fanglinbin1@163.com;ZHENG Biao,E-mail：262814381@qq.com
关键词:
频域光学相干断层扫描; 早期视盘水肿; 视盘周围视网膜总厚度; 灵敏度; 特异度
Keywords:
spectral domain-optical coherence tomography; early stage optic disc edema; circumpapillary total retinal thickness; sensitivity; specificity
分类号:
R774.6
DOI:
10.13389/j.cnki.rao.2020.0010
文献标志码:
A
摘要:
目的　评估频域光学相干断层扫描（spectral domain-optical coherence tomography，SD-OCT）测量的视盘周围视网膜总厚度（circumpapillary total retinal thickness，cpTRT）在早期视盘水肿（early stage optic disc edema，ESODE）诊断中的应用。方法　选取2013年1月至2018年6月在广东医科大学附属医院眼科诊断为ESODE患者50例为ESODE组，并选取同期就诊的无内眼疾病的慢性泪囊炎、共同性斜视、结膜炎且视力正常、屈光间质透明的患者101例作为对照组，使用SD-OCT的3D disk扫描方式扫描视盘，自动得出上方、下方、鼻侧、颞侧象限和平均cpTRT值，评估各cpTRT对ESODE的诊断效能。结果　cpTRT的组内相关性为0.888~0.986；ESODE组平均和各象限cpTRT均较对照组明显增厚（均为P<0.001）；cpTRT在诊断ESODE时，平均、上方象限、下方象限、鼻侧象限、颞侧象限受试者工作特征曲线的曲线下面积分别为0.952、0.961、0.956、0.857、0.848，约登指数分别为0.807、0.847、0.783、0.636、0.670，在最佳切点的灵敏度分别为82.69%、86.54%、96.15%、67.31%、76.92%，特异度分别为98.02%、98.02%、82.18%、96.04%、90.10%。结论　SD-OCT测得的cpTRT具有准确诊断ESODE的效能，在最佳切点诊断ESODE的灵敏度和特异度均较好，是临床诊断ESODE的敏感指标，值得临床应用和进一步研究。
Abstract:
Objective　To evaluate the role of circumpapillary total retinal thickness （cpTRT） measured with spectral domain-optical coherence tomography（SD-OCT） in the diagnosis of early stage optic disc edema （ESODE）.Methods　The study included 50 patients diagnosed with ESODE in Affiliated Hospital of Guangdong Medical University from January 2013 to June 2018，and 101 control subjects without intraocular disease，optic nerve disease，retinal disease such as chronic dacryocystitis，concomitant strabismus，conjunctivitis，with normal vision and transparent dioptric media receiving treatment in our hospital at the same period.The diagnostic efficiency of cpTRT was evaluated.The optic disc were scanned by 3D disk scanning mode of SD-OCT to automatically calculate cpTRT values at superior quadrant,inferior quadrant,nasal quadrant and temporal quadrant,and mean cpTRT value.The diagnostic efficiency of cpTRT values were evaluated.Results　Intra-group correlation of cpTRT by SD-OCT was 0.888 to 0.986.Mean cpTRT and cpTRT at each quadrant in ESODE group were obviously thicker than that in control group（all P<0.01）；for the diagnosis of ESODE by cpTRT measurements，mean area under the curve(AUC) and AUC at four values （superior，inferior，nasal，and temporal） quadrants were 0.952，0.961，0.956，0.857 and 0.848，Youden index were 0.807，0.847，0.783，0.636 and 0.670；the sensitivity at the optimal cut-off value were 82.69%，86.54%，96.15%，67.31% and 76.92%；the specificity were 98.02%，98.02%，82.18%，96.04% and 90.10%.Conclusion　CpTRT by SD-OCT has the performance of accurate diagnosis of ESODE.It has good sensitivity and specificity for the diagnosis of ESODE at the optimal cut-off curve.As a sensitive indictor of clinical diagnosis of ESODE，it is worthy of clinical application and further study.

参考文献/References:

［1］　REBOLLEDA G，MUOZ-NEGRETE F J.Follow-up of mild papilledema in idiopathic intracranial hypertension with optical coherence tomography［J］.Invest Ophthalmol Vis Sci，2009，50（11）：5197-5200.
［2］　El-DAIRI M A，HOLGADO S，O’DONNELL T，BUCKLEY E G，ASRANI S，FREEDMAN F.Optical coherence tomography as a tool for monitoring pediatric pseudotumor cerebri［J］.J AAPOS，2007，11（6）：564-570.
［3］　WANG J K，KARDON R H，KUPERSMITH M J，GARVIN M K.Automated quantification of volumetric optic disc swelling in papilledema using spectral-domain optical coherence tomography［J］.Invest Ophthalmol Vis Sci，2012，53（7）：4069-4075.
［4］　MORENO-MONTAS J，ANTN A，OLMO N，BONET E，ALVAREZ A，BARRIO-BARRIO J，et al.Misalignments in the retinal nerve fiber layer evaluation using cirrus high-definition optical coherence tomography［J］.J Glaucoma，2011，20（9）：559-565.
［5］　LEAL-FONSECA M，REBOLLEDA G，OBLANCA N，MORENO-MONTANES J，MUNOZ-NEGRETE F J.A comparison of false positives in retinal nerve fiber layer，optic nerve head and macular ganglion cell-inner plexiform layer from two spectral-domain optical coherence tomography devices［J］.Graefes Arch Clin Exp Ophthalmol，2014，252（2）：321-330.
［6］　YI K，MUJAT M，SUN W，PARK B H，de BOER J F，CHEN T C.Peripapillary retinal thickness maps in the evaluation of glaucoma patients：a novel concept［J］.ISRN Ophthalmol，2011：146813.
［7］　SKAU M，YRI H，SANDER B，GERDS TA，MILEA D，JENSEN R.Diagnostic value of optical coherence tomography for intracranial pressure in idiopathic intracranial hypertension［J］.Graefes Arch Clin Exp Ophthalmol，2013，251（2）：567-574.
［8］　SIMAVLI H，QUE C J，AKDUMAN M，RIZZO J L，TSIKATA E，de BOER J F，et al.Diagnostic capability of peripapillary retinal thickness in glaucoma using 3D volume scans［J］.Am J Ophthalmol，2015，159（3）：545-556.
［9］　KITA Y，HOLLO G，KITA R，HORIE D，INOUE M，Hirakata A.Differences of intrasession reproducibility of circumpapillary total retinal thickness and circumpapillary retinal nerve fiber layer thickness measurements made with the rs-3000 optical coherence tomograph［J］.PLoS One，2015，10（12）：e0144721.
［10］　MCGRAW K，WONG S.Forming inferences about some intraclass correlation coefficients［J］.Psychol Methods，1996，1（4）：30-46.
［11］　WU H，DE BOER J F，CHEN T C.Diagnostic capability of spectral-domain optical coherence tomography for glaucoma［J］.Am J Ophthalmol，2012，153（5）：815-826.
［12］　郑彪，彭红娟，柯毅，方林彬，黎宗汉.视盘水肿患者视盘周围区域厚度参数的改变［Ｊ］.眼科新进展，2017，37（10）：1057-1058.
ZHENG B，PENG H J，KE Y，FANG L B，LI Z H.Changes in circumpapillary thickness parameters measured by optical coherence tomography in patients with optic disc edema［J］.Rec Adv Ophthalmol，2017，37（10）：1057-1058.
［13］　SCOTT C J，KARDON R H，LEE A G，FRISN L，WALL M.Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale［J］.Arch Ophthalmol，2010，128（6）：705-711.
［14］　LUO J，XIONG C.Youden index and associated cut-points for three ordinal diagnostic groups［J］.Commun Stat Simul Comput，2013，42（6）：1213-1234.
［15］　FLUSS R，FARAGGI D，REISER B.Estimation of the Youden Index and its associated cutoff point［J］.Biom J，2005，47（4）：458-472.
［16］　MAHRAM M，OVEISI S，JABERI N.Trans-cutaneous bilirubinometery versus serum bilirubin in neonatal jaundice［J］.Acta Med Iran，2015，539（12）：764-769.

相似文献/References:

[1]罗洁 赵菊莲 李小平 陆莹 熊小艳.频域光学相干断层扫描对糖尿病患者黄斑部视网膜厚度分区测定的研究[J].眼科新进展,2012,32(2):000.
[2]金昱 石安娜 刘维锋 石浔 王永波.频域OCT在光动力疗法治疗病理性近视脉络膜新生血管中的应用[J].眼科新进展,2012,32(10):000.
[3]施晨蕾 王亚冬.湿性年龄相关性黄斑变性患者光感受器细胞层变化与视力的相关性研究[J].眼科新进展,2013,33(11):000.
[4]刘刚 尤建忠 贾万程 张淑萍. 频域OCT检测不同视网膜脱离复位术后黄斑中心凹视网膜厚度变化与视功能的关系[J].眼科新进展,2014,34(1):082.
[5]刘广峰 顾铮 范颖 孟忻 高新晓 蔺洁 王华 贾羽颂 付秀稳 汪军. 急性区域性隐匿性外层视网膜病变频域光学相干断层扫描图像的特征分析[J].眼科新进展,2014,34(2):147.
[6]牛超,李舒茵,李娜.视网膜色素变性黄斑区视网膜FD-OCT及mfERG观察[J].眼科新进展,2014,34(12):1161.[doi:10.13389/j.cnki.rao.2014.0322]
　NIU Chao,LI Shu-Yin,LI Na.Observation of macular retina using frequency domain optical coherence tomography and multifocal electroretinogram in retinitis pigmentosa[J].Recent Advances in Ophthalmology,2014,34(1):1161.[doi:10.13389/j.cnki.rao.2014.0322]
[7]罗洁,杨海军,李小平. 频域OCT与FFA在糖尿病视网膜病变患者中的应用[J].眼科新进展,2015,35(5):463.[doi:10.13389/j.cnki.rao.2015.0126]
　LUO Jie,YANG Hai-Jun,LI Xiao-Ping. Application comparative study on frequency domain OCT and FFA in patients with diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(1):463.[doi:10.13389/j.cnki.rao.2015.0126]
[8]童桂芳,周琼,邵毅. 急性中心性浆液性脉络膜视网膜病变FFA与频域OCT图像对比研究[J].眼科新进展,2015,35(8):735.[doi:10.13389/j.cnki.rao.2015.0201]
　TONG Gui-Fang,ZHOU Qiong,SHAO Yi. A comparative study on image of FFA and FD-OCT in acute central serous chorioretinopathy[J].Recent Advances in Ophthalmology,2015,35(1):735.[doi:10.13389/j.cnki.rao.2015.0201]
[9]刘雪莲,白宁艳,李治清,等.视网膜脉络膜深层扫描在老年性黄斑变性患者诊断中的作用[J].眼科新进展,2015,35(10):952.[doi:10.13389/j.cnki.rao.2015.0259]
　LIU Xue-Lian,BAI Ning-Yan,LI Zhi-Qing,et al.Role of retinal choroidal deep scan in diagnosis of age-related macular degeneration[J].Recent Advances in Ophthalmology,2015,35(1):952.[doi:10.13389/j.cnki.rao.2015.0259]
[10]黄定国,黄惠春,张安琳,等.频域OCT观察两种类型视网膜脱离术后黄斑中心凹结构变化[J].眼科新进展,2016,36(12):1176.[doi:10.13389/j.cnki.rao.2016.0313]
　HUANG Ding-Guo,HUANG Hui-Chun,ZHANG An-Lin,et al.Changes in foveal microstructure after surgery for two types of retinal detachment with spectral-domain OCT[J].Recent Advances in Ophthalmology,2016,36(1):1176.[doi:10.13389/j.cnki.rao.2016.0313]

备注/Memo

备注/Memo:
湛江市非资助科技攻关计划项目（编号：180606106-83558）
更新日期/Last Update: 2020-01-05