دورية أكاديمية

Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio

التفاصيل البيبلوغرافية
العنوان: Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio
المؤلفون: Kleerekooper, Iris, Wagner, Siegfried K, Trip, S Anand, Plant, Gordon T, Petzold, Axel, Keane, Pearse A, Khawaja, Anthony P
بيانات النشر: BMJ Publishing Group Ltd
سنة النشر: 2024
المجموعة: HighWire Press (Stanford University)
مصطلحات موضوعية: Glaucoma
الوصف: Background/aims The analysis of visual field loss patterns is clinically useful to guide differential diagnosis of visual pathway pathology. This study investigates whether a novel index of macular atrophy patterns can discriminate between chiasmal compression and glaucoma. Methods A retrospective series of patients with preoperative chiasmal compression, primary open-angle glaucoma (POAG) and healthy controls. Macular optical coherence tomography (OCT) images were analysed for the macular ganglion cell and inner plexiform layer (mGCIPL) thickness. The nasal hemi-macula was compared with the temporal hemi-macula to derive the macular naso-temporal ratio (mNTR). Differences between groups and diagnostic accuracy were explored with multivariable linear regression and the area under the receiver operating characteristic curve (AUC). Results We included 111 individuals (31 with chiasmal compression, 30 with POAG and 50 healthy controls). Compared with healthy controls, the mNTR was significantly greater in POAG cases (β=0.07, 95% CI 0.03 to 0.11, p=0.001) and lower in chiasmal compression cases (β=−0.12, 95% CI −0.16 to –0.09, p<0.001), even though overall mGCIPL thickness did not discriminate between these pathologies (p=0.36). The mNTR distinguished POAG from chiasmal compression with an AUC of 95.3% (95% CI 90% to 100%). The AUCs when comparing healthy controls to POAG and chiasmal compression were 79.0% (95% CI 68% to 90%) and 89.0% (95% CI 80% to 98%), respectively. Conclusions The mNTR can distinguish between chiasmal compression and POAG with high discrimination. This ratio may provide utility over-and-above previously reported sectoral thinning metrics. Incorporation of mNTR into the output of OCT instruments may aid earlier diagnosis of chiasmal compression.
نوع الوثيقة: text
وصف الملف: text/html
اللغة: English
العلاقة: http://bjo.bmj.com/cgi/content/short/108/5/695Test; http://dx.doi.org/10.1136/bjo-2023-323529Test
DOI: 10.1136/bjo-2023-323529
الإتاحة: https://doi.org/10.1136/bjo-2023-323529Test
http://bjo.bmj.com/cgi/content/short/108/5/695Test
حقوق: Copyright (C) 2024, BMJ Publishing Group Ltd
رقم الانضمام: edsbas.7A452AC4
قاعدة البيانات: BASE