频域光学相干断层扫描测量青光眼视盘旁萎缩区的可重复性研究  

Reproducibility study of peripapillary atrophy measuring with spectral-domain optical coherence tomography in glaucoma

作　　者：马小力[1] 刘贤洁[1] 陈禹橦 李丹丹[1] 张宏伟[1] 曲勃[2] 

机构地区：[1]中国医科大学附属第一医院眼科,辽宁沈阳110001 [2]中国医科大学附属第四医院眼科,辽宁沈阳110001

出　　处：《解剖科学进展》2016年第2期155-158,共4页Progress of Anatomical Sciences

基　　金：国家自然科学基金(81200656);辽宁省博士启动基金(20111097)

摘　　要：目的利用频域光学相干断层扫描（SD-OCT）和眼底照相方法测量青光眼视盘旁萎缩区,并比较二者对观察者内和观察者间可重复性。方法连续收集就诊于中国医科大学附属第一医院的青光眼患者30例（54只眼）,进行视盘SD-OCT检查和眼底彩色立体照相。分别测量以视盘为中心6条子午线上视盘旁萎缩区β区宽度并计算平均值,比较2种检查的组内标准差（Sw）、变异系数（CV）、组内相关系数（ICC）和Bland-Altman分析图的95%的一致性界限（LoA）。结果眼底照相法和SD-OCT方法测量PPA-β宽度,观察者内Sw分别为32.69μm和6.76μm,CV分别为14.11%和3.28%,ICC分别为0.899（95%CI 0.833-0.940）和0.995（0.992-0.997）,95%LoA分别为（-92.89,89.96）μm和（-20.59,16.21）μm;观察者间Sw分别为39.97μm和10.13μm,CV分别为15.99%和5.09%,ICC分别为0.827（95%CI 0.719-0.896）和0.989（95%CI 0.981-0.994）,95%LoA分别为（-100.1,120.0）μm和（-25.36,30.45）μm;观察者间和观察者内重复性SD-OCT法均优于眼底照相法。结论测量青光眼视盘旁萎缩区β区,SD-OCT法测量结果重复性优于眼底彩色照相法。Objective To study intraobserver and interobserver reproducibility of peripapillary atrophy（PPA）measurements in glaucoma with high-resolution spectral domain-optical coherence tomography（SD-OCT）and conventional color fundus photograph.Methods Fifty-four eyes of 30 patients with glaucoma from the First Hospital of China Medical University were prospectively included.SD-OCT images and color fundus photographs taken through the region of PPA were qualitatively analyzed.The average width of β-PPA area in 6 reference lines centered optic nerve were measured using SDOCT and color fundus photograph.Within-subject standard deviation（Sw）,coefficient of variation（CV）,intraclass correlation coefficient（ICC）and 95% limits of agreements（LoA）of Bland-Altman analysis were assessed using the two measuring methods.Results Regarding intraobserver repeatability using color fundus photograph and SD-OCT,Sw was 32.69μm and 6.76μm,CV was 14.11% and 3.28%,ICC was 0.899（95% CI 0.833-0.940）and 0.995（0.992-0.997）,and 95%LoA was（-92.89,89.96）μm and（-20.59,16.21）μm,respectively.Regarding interobserver reproducibility using color fundus photograph and SD-OCT,Sw was 39.97μm and 10.13μm,CV was 15.99% and 5.09%,ICC was 0.827（95% CI 0.719-0.896）and 0.989（95% CI 0.981-0.994）,and 95%LoA was（-100.1,120.0）μ m and（-25.36,30.45）μ m,respectively.SD-OCT had higher intraobserver and interobserver reproducibility for measurements of β-PPA than color fundus photograph.Conclusion For measurements of β-PPA,SD-OCT had higher reproducibility than color fundus photograph.

关 键 词：青光眼 视盘旁萎缩区 频域光学相干断层扫描 

分 类 号：R775.1[医药卫生—眼科]