AIM:To investigate macular microperimetry in patients with early primary open angle glaucoma(POAG)using a new custom-made pattern,and analyze the characteristics of macular sensitivity.METHODS:This case-control study ...AIM:To investigate macular microperimetry in patients with early primary open angle glaucoma(POAG)using a new custom-made pattern,and analyze the characteristics of macular sensitivity.METHODS:This case-control study included 38 patients with POAG,who were divided into pre-perimetric glaucoma(18 eyes of 18 patients),early-stage(20 eyes of 20 patients),and control(20 eyes of 20 patients)groups.All subjects underwent standard 24-2 humphrey visual field test.An MP-3 microperimeter with a new custom-made pattern(28 testing points distributed in four quadrants,covering the central 10°of the retina)was used to evaluate macular sensitivity.Ganglion cell complex(GCC)thicknesses were examined using an RS-3000 Advance OCT system.The features of structure and function were analysed per quadrant.RESULTS:The pre-perimetric glaucoma group had significantly lower inferior hemifield macular sensitivity compared to controls(P<0.05).The early-stage POAG group had significantly lower average,inferior hemifield,inferonasal,and inferotemporal mean sensitivities compared to the pre-perimetric glaucoma group(P<0.05),and lower macular sensitivity in all sectors compared to controls(P<0.05).Regarding GCC thickness,all sectors in the early-stage POAG group became thinner compared to those in controls(P<0.05);whereas all sectors in the early-stage POAG group,except the superonasal quadrant,became thinner compared to those in the pre-perimetric glaucoma group(P<0.05).Macular sensitivity and GCC thickness were significantly associated in each sector.The inferotemporal quadrant had the highest correlation coefficients(0.840).The structure-function relationship for the inferonasal and inferotemporal sectors was stronger compared to the corresponding superior sectors.CONCLUSION:Microperimetry reveals variations in macular sensitivity in patients with early glaucoma earlier than conventional perimetry,particularly in pre-perimetric glaucoma cases in which it might be undetectable by conventional methods.The new custom-made pattern may improve the accuracy of microperimetry by enhancing point arrangement and reducing fatigue effects.Macular sensitivity measured by MP-3 with this pattern shows statistically significant structural and functional associations with the thicknesses of the GCC.展开更多
Background Optical coherence tomography （OCT） is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure.This study was designed to evaluate the diagnostic ...Background Optical coherence tomography （OCT） is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure.This study was designed to evaluate the diagnostic capability of parameters of the optic disc, retinal nerve fiber layer thickness, and ganglion cell complex （GCC） using a new technology called Fourier-domain OCT （FD-OCT） for early primary open angle glaucoma （POAG） patients.Methods Two groups of patients, early perimetric damage POAG and normal subjects were included in this observational cross-sectional study.All patients underwent FD-OCT and visual field examination in addition to full ophthalmic examinations.Receiver operating characteristic curves （ROC） were studied for all parameters.The sensitivity and specificity for distinguishing between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves （AROC） and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters using arbitrary cutoffs.Results Thirty-four eyes of 34 early POAG patients and 42 eyes of 42 normal subjects were analyzed.Cup/disc （C/D）vertical ratio presented the best sensitivity and positive likelihood ratio for selected specificities （95% and 85%） which were 79.4% and 88.2%, 33.4 and 7.4, respectively.Among all single parameters, the C/D vertical ratio demonstrated the highest AROC which was at 0.930.The average thickness of circumpapillary RNFL on 3.45 mm showed the highest AROC among all of the peripapillary RNFL parameters.The sensitivity at selected specificity and AROC of GCC were not as high as C/D vertical ratio and RNFL AT on 3.45 mm.When the C/D vertical ratio, RNFL AT on 3.45 mm, and rim area were combined using a logistical diagnostic model, the AROC was raised to 0.949 but not significantly different from the top single parameter, C/D vertical ratio.Conclusions The key parameters obtained by FD-OCT were able to show the significant differences of optic discs,thickness of RNFL and GCC between POAG patients and normal subjects.According to sensitivity, specificity, likelihood ratio and AROC, the top three parameters from FD-OCT for early diagnosis of POAG were C/D vertical ratio, RNFL AT on 3.45 mm, and the rim area.展开更多
基金Hebei Medical Science Research Project Program(No.20230067).
文摘AIM:To investigate macular microperimetry in patients with early primary open angle glaucoma(POAG)using a new custom-made pattern,and analyze the characteristics of macular sensitivity.METHODS:This case-control study included 38 patients with POAG,who were divided into pre-perimetric glaucoma(18 eyes of 18 patients),early-stage(20 eyes of 20 patients),and control(20 eyes of 20 patients)groups.All subjects underwent standard 24-2 humphrey visual field test.An MP-3 microperimeter with a new custom-made pattern(28 testing points distributed in four quadrants,covering the central 10°of the retina)was used to evaluate macular sensitivity.Ganglion cell complex(GCC)thicknesses were examined using an RS-3000 Advance OCT system.The features of structure and function were analysed per quadrant.RESULTS:The pre-perimetric glaucoma group had significantly lower inferior hemifield macular sensitivity compared to controls(P<0.05).The early-stage POAG group had significantly lower average,inferior hemifield,inferonasal,and inferotemporal mean sensitivities compared to the pre-perimetric glaucoma group(P<0.05),and lower macular sensitivity in all sectors compared to controls(P<0.05).Regarding GCC thickness,all sectors in the early-stage POAG group became thinner compared to those in controls(P<0.05);whereas all sectors in the early-stage POAG group,except the superonasal quadrant,became thinner compared to those in the pre-perimetric glaucoma group(P<0.05).Macular sensitivity and GCC thickness were significantly associated in each sector.The inferotemporal quadrant had the highest correlation coefficients(0.840).The structure-function relationship for the inferonasal and inferotemporal sectors was stronger compared to the corresponding superior sectors.CONCLUSION:Microperimetry reveals variations in macular sensitivity in patients with early glaucoma earlier than conventional perimetry,particularly in pre-perimetric glaucoma cases in which it might be undetectable by conventional methods.The new custom-made pattern may improve the accuracy of microperimetry by enhancing point arrangement and reducing fatigue effects.Macular sensitivity measured by MP-3 with this pattern shows statistically significant structural and functional associations with the thicknesses of the GCC.
文摘Background Optical coherence tomography （OCT） is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure.This study was designed to evaluate the diagnostic capability of parameters of the optic disc, retinal nerve fiber layer thickness, and ganglion cell complex （GCC） using a new technology called Fourier-domain OCT （FD-OCT） for early primary open angle glaucoma （POAG） patients.Methods Two groups of patients, early perimetric damage POAG and normal subjects were included in this observational cross-sectional study.All patients underwent FD-OCT and visual field examination in addition to full ophthalmic examinations.Receiver operating characteristic curves （ROC） were studied for all parameters.The sensitivity and specificity for distinguishing between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves （AROC） and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters using arbitrary cutoffs.Results Thirty-four eyes of 34 early POAG patients and 42 eyes of 42 normal subjects were analyzed.Cup/disc （C/D）vertical ratio presented the best sensitivity and positive likelihood ratio for selected specificities （95% and 85%） which were 79.4% and 88.2%, 33.4 and 7.4, respectively.Among all single parameters, the C/D vertical ratio demonstrated the highest AROC which was at 0.930.The average thickness of circumpapillary RNFL on 3.45 mm showed the highest AROC among all of the peripapillary RNFL parameters.The sensitivity at selected specificity and AROC of GCC were not as high as C/D vertical ratio and RNFL AT on 3.45 mm.When the C/D vertical ratio, RNFL AT on 3.45 mm, and rim area were combined using a logistical diagnostic model, the AROC was raised to 0.949 but not significantly different from the top single parameter, C/D vertical ratio.Conclusions The key parameters obtained by FD-OCT were able to show the significant differences of optic discs,thickness of RNFL and GCC between POAG patients and normal subjects.According to sensitivity, specificity, likelihood ratio and AROC, the top three parameters from FD-OCT for early diagnosis of POAG were C/D vertical ratio, RNFL AT on 3.45 mm, and the rim area.
