Purpose

To review the current published literature on the use of spectral domain (SD) OCT to help detect changes associated with the diagnosis of glaucoma.

Methods

Searches of the peer-reviewed literature were conducted on June 11, 2014, November 7, 2016, August 8, 2017, and April 19, 2018, in the PubMed and Cochrane Library databases and included only articles published since the last glaucoma imaging Ophthalmic Technology Assessment, which included articles up until February 2006. The abstracts of these 708 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 74 articles were selected, and the panel methodologist (K.N.-M.) assigned ratings to them according to the level of evidence. Two articles were rated level I, 57 articles were rated level II, and the 15 level III articles were excluded.

Results

Spectral-domain OCT is capable of detecting damage to the retinal nerve fiber layer (RNFL), macula, and optic nerve in patients with preperimetric and perimetric glaucoma (level I and II evidence). The most commonly studied single parameter was RNFL thickness. Of note, RNFL thickness measurements are not interchangeable between instruments. Various commercially available SD OCT instruments have similar abilities to distinguish patients with known glaucoma from normal subjects. Despite different software protocols, all SD OCT instruments are able to detect the same typical pattern of glaucomatous RNFL loss that affects primarily the inferior, inferior temporal, superior, and superior temporal regions of the optic nerve (level II evidence). Across many SD OCT instruments, macular imaging also can detect a preferential inferior, inferior temporal, and superior temporal thinning in patients with glaucoma compared with controls. Best disc parameters for detecting glaucomatous nerve damage are global rim area, inferior rim area, and vertical cup-to-disc ratio. Studies suggest that newer reference-plane independent optic nerve parameters may have the same or better detection capability when compared with older reference-plane dependent disc parameters (level II evidence).

Conclusions

Structural glaucomatous damage can be detected by SD OCT. Optic nerve, RNFL, and macular parameters can help the clinician distinguish the anatomic changes that are associated with patients with glaucoma when compared with normal subjects.

中文翻译：

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光谱域OCT：帮助临床医生诊断青光眼

目的

回顾当前有关使用频谱域（SD）OCT来帮助检测与青光眼诊断相关的变化的文献。

方法

于2014年6月11日，2016年11月7日，2017年8月8日和2018年4月19日在PubMed和Cochrane图书馆数据库中进行同行评审文献的检索，仅包括自上次青光眼成像眼科技术以来发表的文章。评估，其中包括直到2006年2月的文章。对这708条文章的摘要进行了审查，以排除评论和非英语文章。在应用纳入和排除标准后，选择了74篇文章，小组方法学家（KN-M。）根据证据水平为其指定了等级。I级有2条，II级有57条，III级15条被排除在外。

结果

光谱域OCT能够检测出围手术期和围手术期青光眼患者的视网膜神经纤维层（RNFL），黄斑和视神经受损（I级和II级证据）。最常研究的单个参数是RNFL厚度。值得注意的是，仪器之间的RNFL厚度测量不可互换。各种市售的SD OCT仪器具有相似的能力，可将已知的青光眼患者与正常受试者区分开。尽管软件协议不同，但是所有SD OCT仪器都能够检测出主要影响视神经下，颞下，上，上颞上区域的青光眼RNFL丢失的相同典型模式（II级证据）。在许多SD OCT仪器中，黄斑成像还可以检测优先的下，颞下，与对照组相比，青光眼患者的颞上皮变薄。用于检测青光眼神经损伤的最佳椎间盘参数是整体边缘区域，下边缘区域和垂直杯碟比。研究表明，与较老的参照平面相关的椎间盘参数相比，较新的参照平面独立的视神经参数可能具有相同或更好的检测能力（II级证据）。

结论

SD OCT可检测到结构性青光眼损害。与正常受试者相比，视神经，RNFL和黄斑参数可帮助临床医生区分与青光眼患者相关的解剖学变化。