Akagi Tadamichi, Iida Yuto, Nakanishi Hideo, Terada Noriko, Morooka Satoshi, Yamada Hiroshi, Hasegawa Tomoko, Yokota Satoshi, Yoshikawa Munemitsu, Yoshimura Nagahisa
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Am J Ophthalmol. 2016 Aug;168:237-249. doi: 10.1016/j.ajo.2016.06.009. Epub 2016 Jun 11.
To investigate microcirculation of peripapillary retina and optic disc in eyes with primary open-angle glaucoma (POAG) and hemifield visual field (VF) defects.
Prospective observational case series with normal comparison group.
Sixty eyes with POAG (41 with superior and 19 with inferior hemifield VF defects) and 21 normal eyes were included in this study. Optical coherence tomography (OCT) angiography was used to acquire 3 × 3-mm optic disc cubes, and circumpapillary retinal nerve fiber layer thickness was also measured using OCT. Vessel densities in the peripapillary superficial retina and whole-signal-mode optic disc were individually analyzed based on the sectorial division.
The peripapillary vessel densities were significantly reduced at the corresponding location of the VF defects in both non-highly myopic (P < .001, P = .006) and highly myopic glaucomatous eyes (P < .001, P = .005) compared with the normal eyes. Vessel densities of the optic discs were significantly reduced at locations corresponding to the VF defects in eyes without high myopia but with inferior hemifield VF defects (P = .006), but not in the other eyes. The vessel densities in the peripapillary retina were significantly associated with visual field total deviation values at their corresponding sides. The choroidal microvascular reduction in the peripapillary area extended to the α-peripapillary atrophy (PPA) as well as β-PPA zones.
Microvascular reduction was associated with VF defects in a region-specific manner: significantly and partially in the peripapillary retina and optic disc, respectively.
研究原发性开角型青光眼（POAG）伴半侧视野（VF）缺损患者视乳头周围视网膜和视盘的微循环情况。
设有正常对照组的前瞻性观察性病例系列研究。
本研究纳入60只POAG患眼（41只患眼为上半侧视野缺损，19只患眼为下半侧视野缺损）和21只正常对照眼。使用光学相干断层扫描（OCT）血管造影获取3×3 mm的视盘立方体图像，并使用OCT测量视乳头周围视网膜神经纤维层厚度。基于扇形分区分别分析视乳头周围浅层视网膜和全信号模式视盘的血管密度。
与正常眼相比，非高度近视（P <.001，P =.006）和高度近视性青光眼患眼（P <.001，P =.005）视乳头周围相应于视野缺损部位的血管密度均显著降低。在无高度近视但有下半侧视野缺损的患眼中，视盘相应于视野缺损部位的血管密度显著降低（P =.006），但在其他患眼中未见明显降低。视乳头周围视网膜的血管密度与其相应侧的视野总偏差值显著相关。视乳头周围区域脉络膜微血管减少延伸至α-视乳头周围萎缩（PPA）以及β-PPA区域。
微血管减少与视野缺损存在区域特异性关联：分别在视乳头周围视网膜和视盘显著且部分相关。
