Xu H, Kong X M
Department of Ophthalmology and Visual Science, ENT Hospital, Shanghai Medical College, Key Laboratory of Myopia, Ministry of Health, Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China.
Zhonghua Yan Ke Za Zhi. 2017 Feb 11;53(2):98-103. doi: 10.3760/cma.j.issn.0412-4081.2017.02.006.
To investigate the alteration of retinal microcirculation and structural damage at macular region and evaluate their associations in primary open angle glaucoma (POAG) eyes. Cross-sectional study. Fifty-nine POAG patients (male/femal=35/24) were recruited from July 2015 to December 2015 in Eye, Ear, Nose and Throat Hospital of Fudan University. Twenty-eight eyes of early-stage POAG group (EG), 11 eyes of moderate-stage POAG group (MG) and 20 eyes of severe-stage POAG group (SG) were enrolled in this study. All patients underwent complete ophthalmological examinations and the general information was collected. The macular perfusion parameters (flow index & vessel area density) and the global/hemimacular retina thickness were derived from the 3D angio-retina and retina map procedures in the single optic coherence tomography (OCT) system with split-spectrum amplitude decorrelation angiography (SSADA) algorithm, respectively. One-way ANOVA analysis was conducted to compare the macular perfusion parameters, retinal thickness and visual field defects among three groups. Pearson partial regression analysis was used to calculate the correlations between different variables. The mean flow index and vessel area density of MG eyes were 0.05±0.01 and 60.8%±7.9%, which were significantly lower than those indexes (0.06±0.01; 71.9%±4.6%) in EG eyes (5.11, 0.001; 5.05, 0.01). The full and inner retinal layer thicknesses of MG eyes were (270.3±24.6) μm and (98.4±13.3) μm, which were obviously thinner than those indexes (293.0±12.0 μm, 113.0±7.4 μm) in EG eyes (3.60, 0.01; 4.06, 0.01). However, there was no significant alteration of macular perfusion parameters and retinal thickness between MG and SG eyes. Furthermore, there was a significantly positive correlation between macular perfusion (flow index/vessel area density) and the macular retina thickness (full/inner thickness) (0.35-0.71, All 0.01). The microvascular perfusion and retinal thickness in MG eyes were lower than those in EG eyes. There was significant positive association between the retinal microvascular perfusion and structural damage. Furthermore, the association between microvascular perfusion and inner inferior retinal thickness is the strongest. .
探讨原发性开角型青光眼（POAG）患者黄斑区视网膜微循环改变及结构损伤情况，并评估它们之间的相关性。横断面研究。2015年7月至2015年12月，从复旦大学附属眼耳鼻喉科医院招募了59例POAG患者（男/女 = 35/24）。本研究纳入了早期POAG组（EG）的28只眼、中期POAG组（MG）的11只眼和晚期POAG组（SG）的20只眼。所有患者均接受了全面的眼科检查并收集了一般信息。黄斑灌注参数（血流指数和血管面积密度）以及全视网膜/半侧黄斑视网膜厚度分别通过单光学相干断层扫描（OCT）系统中采用分裂谱幅度去相关血管造影（SSADA）算法的三维血管视网膜成像和视网膜地图程序得出。采用单因素方差分析比较三组患者的黄斑灌注参数、视网膜厚度和视野缺损情况。采用Pearson偏回归分析计算不同变量之间的相关性。MG组患者的平均血流指数和血管面积密度分别为0.05±0.01和60.8%±7.9%，显著低于EG组患者的这些指标（0.06±0.01；71.9%±4.6%）（F = 5.11，P = 0.001；F = 5.05，P = 0.01）。MG组患者的全视网膜层和内层视网膜厚度分别为（270.3±24.6）μm和（98.4±13.3）μm，明显薄于EG组患者的这些指标（293.0±12.0μm，113.0±7.4μm）（t = 3.60，P = 0.01；t = 4.06，P = 0.01）。然而，MG组和SG组患者的黄斑灌注参数和视网膜厚度无显著变化。此外，黄斑灌注（血流指数/血管面积密度）与黄斑视网膜厚度（全层/内层厚度）之间存在显著正相关（r = 0.35 - 0.71，均P < 0.01）。MG组患者的微血管灌注和视网膜厚度低于EG组患者。视网膜微血管灌注与结构损伤之间存在显著正相关。此外，微血管灌注与视网膜内层下侧厚度之间的相关性最强。
