Publication: Comparación de la capacidad diagnóstica de los nuevos softwares de SD-OCT Cirrus y Spectralis
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2022-05-09
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Universidad Complutense de Madrid
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Abstract
Objetivo Evaluar la capacidad diagnóstica de los más recientes softwares de diagnóstico incluidos en los tomógrafos de coherencia óptica de dominio espectral Cirrus y Spectralis. Métodos Estudio transversal en 109 ojos de 109 pacientes consecutivos (50 controles, 29pacientes con glaucoma primario de ángulo abierto incipiente y 30 glaucoma primario de ángulo abierto moderado). Se obtuvieron parámetros basados en apertura de membrana de Bruch con fóvea a disco y segmentación de las capas internas maculares con Spectralis para compararlos con los análisis convencionales de papila y mácula con Cirrus. Se emplearon las áreas bajo las curvas ROC (AUROC) para comparar las capacidades de diagnóstico de los diferentes parámetros y se calculó la sensibilidad yespecificidad y el índice de Youden para cada uno de ellos. Resultados Spectralis logra discriminar mejor entre el grupo de glaucoma incipiente y el glaucoma moderado. Los mejores parámetros de AUROC de los análisis de Spectralis fueron los siguientes: grosor del cuadrante inferotemporal de la RNFL peripapilar (0,725), grosor del cuadrante inferotemporal del BMO (0,711) y grosor del cuadrante temporal externo de la capa plexiforme interna (0,774). En Cirrus los mejores parámetros fueron: espesor del cuadrante inferior de la capa de fibra (0,614) y el espesor del cuadrante inferotemporal de la capa plexiforme interna y las células ganglionares (0,795). Las diferencias significativas en AUROC entre los mejores parámetros de Spectralis y Cirrus oscilaron entre 0,111 y 0,203.Conclusión Utilizando las últimas mejoras diagnósticas incluidas en Cirrus y Spectralis se han encontrado diferencias en términos de rendimiento diagnóstico, Spectralis logra discriminar mejor el glaucoma incipiente del glaucoma moderado...
Objective To evaluate the diagnostic capacity of the most recent diagnostic softwares included in the spectral domain optical coherence tomographers Cirrus and Spectralis. Material and methods A cross-sectional study in 109 eyes of 109 consecutive patients (50 controls, 29 patients with early primary open-angle glaucoma and 30 moderate primary open-angle glaucoma). We obtained parameters based on Bruch membrane aperture with fovea to disc and segmentation of the macular inner layers with Spectralis to compare them with conventional analysis of papilla and macula with Cirrus. The areas under the ROC curves (AUROC) were used to compare the diagnostic capabilities of the different parameters, the sensitivity, specificity and the Youden index were calculated for each of them. Results The best AUROC parameters of the Spectralis analyzes were the following: thickness of the inferotemporal peripapillary RNFL (0.725), thickness of the inferotemporal quadrant of BMO-MRW (0.711) and thickness of the outer temporal quadrant of Inner Plexiform Layer (0.774). In Cirrus the best parameters were: thickness of the lower quadrant of fiber layer (0.614) and the thickness of the inferotemporal quadrant of ganglion cell-inner plexiform layer (0.795). The significant differences in AUROC between the best parameters of Spectralis and Cirrus ranged between 0.111 and 0.203. Conclusion Using the latest diagnostic improvements included in Cirrus and Spectralis, we have found differences in terms of diagnostic yield, Spectralis manages to better discriminate early glaucoma from moderate glaucoma.
Objective To evaluate the diagnostic capacity of the most recent diagnostic softwares included in the spectral domain optical coherence tomographers Cirrus and Spectralis. Material and methods A cross-sectional study in 109 eyes of 109 consecutive patients (50 controls, 29 patients with early primary open-angle glaucoma and 30 moderate primary open-angle glaucoma). We obtained parameters based on Bruch membrane aperture with fovea to disc and segmentation of the macular inner layers with Spectralis to compare them with conventional analysis of papilla and macula with Cirrus. The areas under the ROC curves (AUROC) were used to compare the diagnostic capabilities of the different parameters, the sensitivity, specificity and the Youden index were calculated for each of them. Results The best AUROC parameters of the Spectralis analyzes were the following: thickness of the inferotemporal peripapillary RNFL (0.725), thickness of the inferotemporal quadrant of BMO-MRW (0.711) and thickness of the outer temporal quadrant of Inner Plexiform Layer (0.774). In Cirrus the best parameters were: thickness of the lower quadrant of fiber layer (0.614) and the thickness of the inferotemporal quadrant of ganglion cell-inner plexiform layer (0.795). The significant differences in AUROC between the best parameters of Spectralis and Cirrus ranged between 0.111 and 0.203. Conclusion Using the latest diagnostic improvements included in Cirrus and Spectralis, we have found differences in terms of diagnostic yield, Spectralis manages to better discriminate early glaucoma from moderate glaucoma.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Oftalmología y Otorrinolaringología, leída el 08-02-2022