緑内障の診断におけるブルッフ膜開口部最小縁幅の精度：近視眼における検討

To analyze Bruch's membrane opening minimum rim width (BMO-MRW) for detecting glaucoma in patients with myopia < -6D and assessment of peripapillary retinal nerve fiber layer thickness (pRNFLT).

One eye was randomly selected from each of the 90 subjects (A-30 normal controls, B-30 with glaucoma suspect, and C-30 with primary open-angle glaucoma [POAG]). All patients underwent baseline ophthalmic evaluation. BMO- MRW and pRNFLT data were obtained using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering GmbH, Heidelberg, Germany). The area under the receiver operating characteristic curves (AUC) for global and sectoral thickness parameters was calculated.

Sectoral analysis of BMO-MRW for the discrimination of early glaucoma in all myopic subjects showed significantly better diagnostic performance than pRNFLT in temporal (0.85 (0.77 to 0.94) P = 0.014), temporal superior (TS) (0.90 (0.83 to 0.98) P = 0.005), and nasal inferior quadrants (0.92 (0.86 to 0.97) P = 0.022) with 95% CI. When discriminating early glaucoma from the suspect, overall the diagnostic performance of BMO-MRW was higher than that of pRNFLT, with significant differences in the temperosuperior quadrant (0.85 (0.74 to 0.95) 95% CI, P = 0.047).

BMO-MRW had better diagnostic performance than RNFL thickness and is a useful parameter for detecting glaucoma in myopic eyes (≤-6D) with POAG.