Fard Masoud Aghsaei, Suwan Yanin, Moghimi Sasan, Geyman Lawrence S, Chui Toco Y, Rosen Richard B, Ritch Robert
Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran.
Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
PLoS One. 2018 Jan 10;13(1):e0189237. doi: 10.1371/journal.pone.0189237. eCollection 2018.
Both non-arteritic anterior ischemic optic neuropathy (NAION) and primary open-angle glaucoma (POAG) damage retinal ganglion cell axons, which are perfused by the radial peripapillary capillaries. To evaluate the pattern of ischemia, we compared peripapillary capillary density (PCD) in NAION eyes to POAG eyes matched for visual field mean deviation and retinal nerve fiber layer thickness.
31 chronic NAION (>6 months after the acute event) and unaffected fellow eyes (31 subjects), 42 moderate and severe POAG eyes (27 subjects), and 77 control eyes (46 healthy subjects) were imaged with a commercial optical coherence tomography angiography system (AngioVue, Avanti RTVue-XR, Optovue, CA) at two academic institutions. Two concentric circles of diameters 1.95mm (inner) and 3.45mm (outer) were manually placed on images centered on the optic nerve head, producing an annular region-of-interest. Image analysis with major vessel removal was performed using a custom program. Whole-image, whole-annulus, and sectoral PCDs were measured.
Whole-image and whole-annulus PCDs in NAION and moderate and severe POAG eyes were significantly decreased compared to unaffected fellow eyes and control eyes (all P<0.001). Superior and temporal PCD values were affected more than other sectors in both NAION and POAG groups compared to control group. Whole-image and whole-annulus PCDs were not statistically different between NAION and POAG eyes (both P = 0.99). However, of all peripapillary sectors, the inferior sector PCD value was less affected in POAG eyes compared to NAION eyes (P = 0.001). Univariate analysis results also revealed a significant positive correlation between superior and inferior PCDs and corresponding RNFL thicknesses. The inferior sector correlation was greater in POAG than NAION eyes.
While the whole PCD values were not different in chronic NAION and POAG, the greater correlation of inferior PCD with corresponding RNFL sectors in POAG compared to NAION suggests greater susceptibility of the inferior radial peripapillary capillary in the pathogenesis of POAG.
非动脉炎性前部缺血性视神经病变（NAION）和原发性开角型青光眼（POAG）都会损害由视乳头周围放射状毛细血管灌注的视网膜神经节细胞轴突。为了评估缺血模式，我们比较了NAION患眼与视野平均偏差和视网膜神经纤维层厚度相匹配的POAG患眼的视乳头周围毛细血管密度（PCD）。
在两家学术机构，使用商用光学相干断层扫描血管造影系统（AngioVue，Avanti RTVue-XR，Optovue，加利福尼亚州）对31例慢性NAION患者（急性事件发生后>6个月）及其未受影响的对侧眼（31名受试者）、42例中重度POAG患眼（27名受试者）和77只对照眼（46名健康受试者）进行成像。在以视神经乳头为中心的图像上手动放置两个直径分别为1.95mm（内）和3.45mm（外）的同心圆，形成一个环形感兴趣区域。使用定制程序进行去除主要血管后的图像分析。测量全图像、全环和扇形PCD。
与未受影响的对侧眼和对照眼相比，NAION患眼以及中重度POAG患眼的全图像和全环PCD均显著降低（所有P<0.001）。与对照组相比，NAION组和POAG组的上方和颞侧PCD值受影响程度大于其他扇形区域。NAION患眼和POAG患眼的全图像和全环PCD在统计学上无差异（两者P = 0.99）。然而，在所有视乳头周围扇形区域中，与NAION患眼相比，POAG患眼的下方扇形区域PCD值受影响较小（P = 0.001）。单因素分析结果还显示上方和下方PCD与相应的视网膜神经纤维层厚度之间存在显著正相关。POAG患眼下方扇形区域的相关性大于NAION患眼。
虽然慢性NAION和POAG的整体PCD值没有差异，但与NAION相比，POAG中下方PCD与相应视网膜神经纤维层扇形区域的相关性更高，这表明在POAG发病机制中，下方视乳头周围放射状毛细血管的易损性更大。
