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临床单侧假性剥脱综合征患者双眼之间视网膜血管直径与青光眼参数的比较。

Comparisons of retinal vessel diameter and glaucomatous parameters between both eyes of subjects with clinically unilateral pseudoexfoliation syndrome.

作者信息

Takai Yasuyuki, Tanito Masaki, Omura Tetsuro, Kawasaki Ryo, Kawasaki Yumiko, Ohira Akihiro

机构信息

Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan.

Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.

出版信息

PLoS One. 2017 Jun 23;12(6):e0179663. doi: 10.1371/journal.pone.0179663. eCollection 2017.

Abstract

PURPOSE

Pseudoexfoliation syndrome (PEX), the most common identifiable cause of open-angle glaucoma, might affect the retinal hemodynamics. To test this, we compared retinal vessel diameter and glaucoma-related parameters between eyes with pseudoexfoliation material (PE+) and fellow unaffected (PE-) eyes of patients with clinically unilateral PEX.

METHODS

The medical records of 30 consecutive Japanese subjects were reviewed retrospectively. The retinal vessel diameters were measured and expressed as the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) using standardized software. During the chart review, we recorded glaucoma-related parameters including intraocular pressure (IOP), visual field mean deviation (MD) value, planimetrically measured vertical cup-to-disc (C/D) ratio, circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and macular inner retinal thickness (mIRT) measured by spectral-domain optical coherence tomography, anterior chamber flare (ACF), corneal endothelial cell density (CECD), and number of antiglaucoma medications.

RESULTS

Compared with PE- eyes, the CRAE, CRVE, MD, cpRNFLT and mIRT, and CECD were significantly lower in PE+ eyes; the IOP, vertical C/D ratio, number of antiglaucoma medications, and ACF were significantly higher in PE+ eyes (P<0.0001 for all comparisons). The CRAE, cpRNFLT, and MD were correlated positively with each other (ρ = 0.456-0.499, P<0.0001-0.0002) and negatively with the IOP (ρ = -0.562- -0.432, P<0.0001-0.0006). The vertical C/D ratio was correlated positively with the IOP (ρ = 0.483, P<0.0001) and negatively with the CRAE, cpRNFLT, and MD (ρ = -0.745--0.479, P<0.0001-0.0001).

CONCLUSIONS

Deposition of PE can cause retinal vessel narrowing in arterioles and venules. The roles and mechanisms of retinal vessel narrowing in glaucoma pathogenesis need clarification.

摘要

目的

假性剥脱综合征(PEX)是开角型青光眼最常见的可识别病因,可能会影响视网膜血流动力学。为验证这一点,我们比较了临床单侧PEX患者有假性剥脱物质的眼(PE+)和对侧未受累眼(PE-)的视网膜血管直径及青光眼相关参数。

方法

回顾性分析30例连续的日本受试者的病历。使用标准化软件测量视网膜血管直径,并表示为视网膜中央动脉等效直径(CRAE)和视网膜中央静脉等效直径(CRVE)。在查阅病历过程中,我们记录了青光眼相关参数,包括眼压(IOP)、视野平均偏差(MD)值、平面测量的垂直杯盘比(C/D)、经光谱域光学相干断层扫描测量的视盘周围视网膜神经纤维层厚度(cpRNFLT)和黄斑部视网膜内层厚度(mIRT)、前房闪辉(ACF)、角膜内皮细胞密度(CECD)以及抗青光眼药物数量。

结果

与PE-眼相比,PE+眼的CRAE、CRVE、MD、cpRNFLT、mIRT和CECD显著降低;PE+眼的IOP、垂直C/D比、抗青光眼药物数量和ACF显著升高(所有比较P<0.0001)。CRAE、cpRNFLT和MD之间呈正相关(ρ = 0.456 - 0.499,P<0.0001 - 0.0002),与IOP呈负相关(ρ = -0.562 - -0.432,P<0.0001 - 0.0006)。垂直C/D比与IOP呈正相关(ρ = 0.483,P<0.0001),与CRAE、cpRNFLT和MD呈负相关(ρ = -0.745 - -0.479,P<0.0001 - 0.0001)。

结论

PE的沉积可导致视网膜小动脉和小静脉狭窄。视网膜血管狭窄在青光眼发病机制中的作用和机制有待阐明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9637/5482447/d5328d4b2a77/pone.0179663.g001.jpg

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