Wang Mengyu, Wang Hui, Pasquale Louis R, Baniasadi Neda, Shen Lucy Q, Bex Peter J, Elze Tobias
Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts.
Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Institute for Psychology and Behavior, Jilin University of Finance and Economics, Changchun, China.
Am J Ophthalmol. 2017 Apr;176:53-60. doi: 10.1016/j.ajo.2017.01.001. Epub 2017 Jan 11.
To study the relationship between horizontal central retinal vessel trunk location (CRVTL) on glaucomatous optic discs and sector-specific visual field (VF) loss.
Retrospective cross-sectional study.
CRVTL of 421 eyes from 421 patients was manually tracked on the horizontal optic disc axis on fundus images. Focal circumpapillary retinal nerve fiber layer thickness (cpRNFLT) measurements were extracted from optical coherence tomography (OCT). The relationship between focal visual field (VF) loss and CRVTL and focal cpRNFLT was studied by linear regression models. Furthermore, we related central VF loss to CRVTL and focal cpRNFLT separately for mild (VF mean deviation [MD] ≥-6 dB), moderate (-12 dB ≤ MD <-6 dB), and severe (MD <-12 dB) glaucoma.
CRVTL nasalization was significantly correlated only to central VF loss (Garway-Heath scheme [central 6 locations, C6]: correlation: r = -0.16, P < .001; macular vulnerability zone [central 2 locations, C2]: r = -0.14, P = .003; central 4 locations [C4]: r = -0.17, P < .001). While focal cpRNFLT at the sectors corresponding to C2 and C6 was significantly correlated to the respective VF sectors as well (C2: r = 0.15, P = .002; C6: r = 0.10, P = .03), multivariate models combining cpRNFLT and CRVTL substantially improved structure-function models compared with cpRNFLT alone (likelihood ratio tests, C2 and C6: P < .001). The correlations between CRVTL and central VF loss of C4 were -0.11 (P = .04), -0.39 (P = .01), and -0.63 (P = .002) for mild, moderate, and severe glaucoma, respectively.
CRVTL nasalization is significantly and exclusively correlated to central VF loss for all glaucoma severities independent of cpRNFLT, and thus might be a structural biomarker of central VF loss.
研究青光眼视盘上视网膜中央血管主干水平位置（CRVTL）与特定扇形视野（VF）缺损之间的关系。
回顾性横断面研究。
在眼底图像上沿视盘水平轴手动追踪421例患者421只眼的CRVTL。从光学相干断层扫描（OCT）中提取局部视盘周围视网膜神经纤维层厚度（cpRNFLT）测量值。通过线性回归模型研究局部视野（VF）缺损与CRVTL及局部cpRNFLT之间的关系。此外，我们分别针对轻度（VF平均偏差[MD]≥ -6 dB）、中度（-12 dB≤MD < -6 dB）和重度（MD < -12 dB）青光眼，将中央VF缺损与CRVTL和局部cpRNFLT进行关联分析。
CRVTL向鼻侧移位仅与中央VF缺损显著相关（Garway-Heath方案[中央6个位置，C6]：相关性：r = -0.16，P <.001；黄斑易损区[中央2个位置，C2]：r = -0.14，P =.003；中央4个位置[C4]：r = -0.17，P <.001）。虽然与C2和C6相对应扇形区域的局部cpRNFLT也分别与各自的VF扇形区域显著相关（C2：r = 0.15，P =.002；C6：r = 0.10，P =.03），但与单独使用cpRNFLT相比，将cpRNFLT和CRVTL结合的多变量模型显著改善了结构-功能模型（似然比检验，C2和C6：P <.001）。对于轻度、中度和重度青光眼，CRVTL与C4中央VF缺损的相关性分别为-0.11（P =.04）、-0.39（P =.0l）和-0.63（P =.002）。
对于所有严重程度的青光眼，CRVTL向鼻侧移位均与中央VF缺损显著且唯一相关，与cpRNFLT无关，因此可能是中央VF缺损的一种结构生物标志物。
