Sources of Discrepancy between Retinal Nerve Fiber Layer and Bruch’s Membrane Opening-Minimum Rim Width Thickness in Eyes with Glaucoma

IF 3.2 Q1 OPHTHALMOLOGY Ophthalmology science Pub Date : 2024-08-22 DOI:10.1016/j.xops.2024.100601
Iris Zhuang MD, Maryam Ashrafkhorasani MD, Vahid Mohammadzadeh MD, Kouros Nouri-Mahdavi MD, MS
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Abstract

Purpose

To compare the discrepancies between circumpapillary retinal nerve fiber layer (RNFL) and Bruch’s membrane opening-minimum rim width (BMO-MRW) thickness in glaucoma eyes.

Design

A cross-sectional observational study.

Subjects

One hundred eighty-six eyes (118 patients) with glaucoma.

Methods

OCT optic nerve head volume scans of patients enrolled in the Advanced Glaucoma Progression Study at the final available visit were exported. The RNFL and BMO-MRW measurements were averaged into corresponding 7.5° sectors, and the nasal sector data were excluded from analyses. A 2-stage screening process was used to identify true mismatches between the RNFL and BMO-MRW measurements, in which either the RNFL or BMO-MRW value was in the less than first percentile range while its counterpart was in the greater than first percentile range on the temporal-superior-nasal-inferior-temporal curve. The prevalence of these mismatches was mapped, and corresponding images were reviewed to determine the underlying cause of these discrepancies.

Main Outcome Measures

Proportion of mismatches between RNFL and BMO-MRW, location of mismatches between RNFL and BMO-MRW, anatomical causes of mismatches between RNFL and BMO-MRW.

Results

Mismatch analysis revealed true mismatches between RNFL and BMO-MRW in 7.7% of sectors. High BMO-MRW with low corresponding RNFL mismatches were most frequently located at the 45° and 322.5° sectors, whereas high RNFL with corresponding low BMO-MRW mismatches peaked at the 75° sector. Large blood vessels accounted for 90.9% of high RNFL with low BMO-MRW mismatches. Small to large blood vessels accounted for 62.9% of high BMO-MRW with low RNFL mismatches; the remaining mismatches could be attributed to retinoschisis or inclusion of outer retinal layers in BMO-MRW measurements.

Conclusions

Although overall agreement between RNFL and BMO-MRW measurements is good in areas with advanced damage, blood vessels and other anatomical factors can cause discrepancies between the 2 types of structural measurements and need to be considered when evaluating the utility of such measurements for detection of change.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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青光眼患者视网膜神经纤维层与布氏膜开口-最小边缘宽度厚度之间差异的来源
目的比较青光眼眼球毛细血管视网膜神经纤维层(RNFL)和布鲁氏膜开口-最小边缘宽度(BMO-MRW)厚度之间的差异。方法导出参加高级青光眼进展研究的患者在最后一次就诊时的OCT视神经头体积扫描数据。将 RNFL 和 BMO-MRW 测量值平均到相应的 7.5° 扇区中,鼻腔扇区数据不纳入分析。采用两阶段筛选过程来识别 RNFL 和 BMO-MRW 测量值之间的真正不匹配,即 RNFL 或 BMO-MRW 值小于第一百分位数范围,而其对应值在颞-上-鼻-下-颞曲线上大于第一百分位数范围。主要结果测量RNFL和BMO-MRW之间不匹配的比例、RNFL和BMO-MRW之间不匹配的位置、RNFL和BMO-MRW之间不匹配的解剖学原因。结果不匹配分析显示7.7%的区域存在RNFL和BMO-MRW之间的真正不匹配。高BMO-MRW与低RNFL错配最常见于45°和322.5°区域,而高RNFL与低BMO-MRW错配在75°区域达到峰值。在 BMO-MRW 低错配的高 RNFL 中,大血管占 90.9%。在 BMO-MRW 偏高而 RNFL 偏低的不匹配中,小到大血管占 62.9%;其余的不匹配可能是由于视网膜裂孔或视网膜外层包含在 BMO-MRW 测量中。结论虽然RNFL和BMO-MRW测量值在晚期损伤区域的总体一致性良好,但血管和其他解剖因素会导致这两种结构测量值之间的差异,因此在评估此类测量值对检测变化的实用性时需要加以考虑。
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来源期刊
Ophthalmology science
Ophthalmology science Ophthalmology
CiteScore
3.40
自引率
0.00%
发文量
0
审稿时长
89 days
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Barriers to Extracting and Harmonizing Glaucoma Testing Data: Gaps, Shortcomings, and the Pursuit of FAIRness Severity Scale of Diabetic Macular Ischemia Based on the Distribution of Capillary Nonperfusion in OCT Angiography Editorial Board Table of Contents Cover
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