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.