【摘要】 目的评估神经节细胞层-视网膜内丛状层厚度(GCIPL)及GCIPL联合神经纤维层厚度(RNFL)参数在诊断青光眼中的作用。方法选择青光眼患者48例(62只眼)及健康志愿者39例(62只眼),分别测试患者每只眼视乳头周边RNFL厚度及黄斑区GCIPL分布图。评估GCIPL、RNFL及GCIPL和RNFL联合参数的敏感性、特异性,阳性似然比(PLR)和阴性似然比(NLR),并判断各参数的诊断效能。结果 GCIPL参数中,下半区域GCIPL厚度有最好的诊断效能,(敏感度88.7%,特异度为98.4%;PLR,55.4;和NLR,0.169)。下四分之一扇区,是RNFL诊断效能最好的参数(灵敏度,90.3%;特异性98.4%;PLR,56.4;和NLR,0.10)。下方区域GCIPL厚度和下四分之一扇区RNFL层厚度的或逻辑的组合具有最佳诊断性能(敏感度96.8%,特异度为98.4%;PRL,60.5;和NLR,0.033),而第6或第7点钟方位RNFL层厚度与下半区域GCIPL层厚度的或逻辑组合拥有最佳的敏感度(敏感度100%,特异度为93.5%;PRL,15.4;和NLR,0)。结论下方区域GCIPL厚度与下四分之一扇区RNFL层厚度的或逻辑的组合具有最佳诊断性能,比单独的GCIPL,RNFL参数拥有更好的诊断性能,该联合参数的使用可以减少一部分早期青光眼的漏诊。更多还原

【Abstract】 Objective To evaluate the diagnostic performance of ganglion cell inner plexiform layer( GCIPL)thickness measured with Der Topcon 3D OCT-2000 for early stage glaucoma. Methods 48 patients with early perimetric glaucoma and 39 age-matched healthy subjects were included in the study. Peripapillary RNFL and macular GCIPL scans were obtained from 1 eye of each participant. The diagnostic performance was determined for each GCIPL,RNFL and for binary or-logic and and-logic combinations of GCIPL with RNFL. Results Among GCIPL parameters,thickness in inferior retina had the best diagnostic performance( sensitivity,88. 7%; specificity,98. 4%; PLR,55. 4; NLR,0. 169). Inferior quadrant was best for RNFL. The or-logic combination of inferior GCIPL thickness and inferior quadrant RNFL thickness provided the overall best diagnostic performance( sensitivity,96. 8%; specificity,98. 4%; PRL,60. 5; NLR,0. 033).The or-logic combination of inferior GCIPL thickness and the 6 clock or 7 clock RNFL provided the best sensitivity( sensitivity 100%; specificity 93. 5%; PRL,15. 4; NLR,0) Conclusions The binary or-logic combination of inferior GCIPL thickness and inferior quadrant RNFL thickness provides better diagnostic performances for early glaucoma. This finding may be clinically valuable for the diagnosis of early glaucoma.更多还原