中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
Chinese Journal of Optometry Ophthalmology and Visual Science
2015年
9期
538-544
,共7页
体层摄影术,光学相干%种族特异性正常人数据库%青光眼,开角型%诊断模型
體層攝影術,光學相榦%種族特異性正常人數據庫%青光眼,開角型%診斷模型
체층섭영술,광학상간%충족특이성정상인수거고%청광안,개각형%진단모형
Tomography,optical coherence%Ethnic-specific database of normal human%Glaucoma,open angle%Diagnosis model
目的 利用频域光学相干断层成像(FD-OCT)的种族特异性正常人数据库,建立简便实用的原发性开角型青光眼(POAG)的诊断模型.方法 横断面研究.对133例(133眼)正常人,99例(99眼)早期POAG患者行RTVue-100 FD-OCT的视神经乳头(ONH)、视网膜神经纤维层3.45 (RNFL3.45)、节细胞复合体(GCC)三项扫描.用扫描参数建立"诊断模型".受检者操作特征曲线(ROC)及曲线下面积(AROC)用来反映FD-OCT的各项参数得分鉴别早期POAG和正常眼的能力.运用logistic回归模型进行参数的联合,建立早期POAG的诊断模型.结果 ①正常人和早期POAG患者2组间的所有ONH、RNFL3.45和GCC扫描单参数的分级评分差异均有统计学意义(P＜0.05).②最佳单一参数为ONH扫描的神经纤维层总体平均厚度(R-A) (AROC=0.912).③"诊断模型"的AROC大于最佳单一参数,差异有统计学意义.③经验证,ONH"诊断模型"的AROC为0.987,RNFL3.45"诊断模型"的AROC为0.959.结论 运用FD-OCT的种族特异性正常人数据库可建立评分系统和"诊断模型",与单参数比较,多参数模型提高了早期POAG的诊断效能,且较简便,便于临床应用.
目的 利用頻域光學相榦斷層成像(FD-OCT)的種族特異性正常人數據庫,建立簡便實用的原髮性開角型青光眼(POAG)的診斷模型.方法 橫斷麵研究.對133例(133眼)正常人,99例(99眼)早期POAG患者行RTVue-100 FD-OCT的視神經乳頭(ONH)、視網膜神經纖維層3.45 (RNFL3.45)、節細胞複閤體(GCC)三項掃描.用掃描參數建立"診斷模型".受檢者操作特徵麯線(ROC)及麯線下麵積(AROC)用來反映FD-OCT的各項參數得分鑒彆早期POAG和正常眼的能力.運用logistic迴歸模型進行參數的聯閤,建立早期POAG的診斷模型.結果 ①正常人和早期POAG患者2組間的所有ONH、RNFL3.45和GCC掃描單參數的分級評分差異均有統計學意義(P＜0.05).②最佳單一參數為ONH掃描的神經纖維層總體平均厚度(R-A) (AROC=0.912).③"診斷模型"的AROC大于最佳單一參數,差異有統計學意義.③經驗證,ONH"診斷模型"的AROC為0.987,RNFL3.45"診斷模型"的AROC為0.959.結論 運用FD-OCT的種族特異性正常人數據庫可建立評分繫統和"診斷模型",與單參數比較,多參數模型提高瞭早期POAG的診斷效能,且較簡便,便于臨床應用.
목적 이용빈역광학상간단층성상(FD-OCT)적충족특이성정상인수거고,건립간편실용적원발성개각형청광안(POAG)적진단모형.방법 횡단면연구.대133례(133안)정상인,99례(99안)조기POAG환자행RTVue-100 FD-OCT적시신경유두(ONH)、시망막신경섬유층3.45 (RNFL3.45)、절세포복합체(GCC)삼항소묘.용소묘삼수건립"진단모형".수검자조작특정곡선(ROC)급곡선하면적(AROC)용래반영FD-OCT적각항삼수득분감별조기POAG화정상안적능력.운용logistic회귀모형진행삼수적연합,건립조기POAG적진단모형.결과 ①정상인화조기POAG환자2조간적소유ONH、RNFL3.45화GCC소묘단삼수적분급평분차이균유통계학의의(P＜0.05).②최가단일삼수위ONH소묘적신경섬유층총체평균후도(R-A) (AROC=0.912).③"진단모형"적AROC대우최가단일삼수,차이유통계학의의.③경험증,ONH"진단모형"적AROC위0.987,RNFL3.45"진단모형"적AROC위0.959.결론 운용FD-OCT적충족특이성정상인수거고가건립평분계통화"진단모형",여단삼수비교,다삼수모형제고료조기POAG적진단효능,차교간편,편우림상응용.
Objective To build a practical and convenient diagnostic model of primary open-angle glaucoma (POAG) using the frequency-domain optical coherence tomography (FD-OCT) ethnic-specific database of normal humans for clinical application.Methods In a cross-sectional observational study, 133 eyes from 133 healthy subjects and 99 eyes from 99 early POAG patients were included in the study.MM 6/Radial slicer, optic nerve head (ONH), retinal nerve fiber layer3.45 (RNFL 3.45) and ganglion cell complex (GCC) scans were measured in each subject with an RTVue-100 FD-OCT.Then, these parameters were used to establish the "diagnostic models".Receiver operating characteristic (ROC) curves and the area under the receiver operating characteristic curve (AROC) were used to reflect the capability of scores for each parameter of the FD-OCT in order to distinguish eyes in early-stage POAG from normal eyes.A combination of parameters was used with logistic regression to establish "diagnostic models" for early POAG.Results ①Significant differences were observed for all grading scores of ONH, RNFL3.45 and GCC scanning parameters between normal and early POAG groups (P＜0.05).②The best single parameter for ONH scanning was the RNFL average (R-A) (AROC, 0.912).③The AROCs of the "diagnosis model" were greater than the best single parameter.Their AROCs had significant differences.④We validated these models.The AROC of the " diagnosis model" in ONH scanning was 0.987 and was 0.959 for RNFL3.45 scanning.Conclusion A multi-parameter "diagnosis model" using FD-OCT parameters and grading based on an ethnic-specific database of normal humans can improve the ability to diagnose early POAG.It may be convenient for clinical application.
