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使用光学相干断层扫描血管造影术测量的血流密度与青光眼患者结构和功能参数的相关性。

Correlation of flow density, as measured using optical coherence tomography angiography, with structural and functional parameters in glaucoma patients.

作者信息

Alnawaiseh Maged, Lahme Larissa, Müller Viktoria, Rosentreter André, Eter Nicole

机构信息

Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany.

Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str, 11, Würzburg, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 Mar;256(3):589-597. doi: 10.1007/s00417-017-3865-9. Epub 2018 Jan 13.

Abstract

PURPOSE

To evaluate the correlation between flow density, as measured by optical coherence tomography angiography (OCTA), and structural and functional parameters in patients with open-angle glaucoma.

METHODS

Thirty-four eyes of 34 patients with open-angle glaucoma and 35 eyes of 35 healthy subjects were prospectively included in this study. OCTA was performed using RTVue XR Avanti with AngioVue. The macula was imaged with a 3 × 3 mm scan and the optic nerve head (ONH) with a 4.5 × 4.5 mm scan. Visual field parameters [mean deviation (MD), pattern standard deviation (PSD) and visual field index (VFI)], Bruch's membrane opening minimal rim width (BMO-MRW), retinal nerve fiber layer thickness (RNFLT) and the stereometric parameters rim area, cup/disc area (HRT III, Heidelberg Retina Tomograph, Heidelberg Engineering) were tested for correlation with flow density data.

RESULTS

The flow density (whole en face) in the retinal OCT angiograms (superficial: p = 0.01; deep: p = 0.005), in the radial peripapillary capillary network (p < 0.001) and in the OCT angiograms of the optic nerve head (p = 0.004) were significantly lower in the glaucoma group when compared with the control group. The flow density in the RPC network correlated significantly with all functional and structural parameters tested. The strongest correlation was found between the RPC flow density (inside disc) and the BMO-MRW (Spearman's correlation coefficient = 0.912, p < 0.001).

CONCLUSIONS

Glaucoma patients showed a reduced ONH and macular perfusion when compared with healthy controls. The flow density as measured by OCTA correlated with structural damage and visual field loss in glaucoma patients. Non-invasive quantitative analyses of flow density using OCTA provide a new parameter describing a different aspect of glaucoma, which could be useful in clinical practice.

摘要

目的

评估通过光学相干断层扫描血管造影(OCTA)测量的血流密度与开角型青光眼患者的结构和功能参数之间的相关性。

方法

本研究前瞻性纳入了34例开角型青光眼患者的34只眼和35例健康受试者的35只眼。使用配备AngioVue的RTVue XR Avanti进行OCTA检查。采用3×3mm扫描对黄斑进行成像,采用4.5×4.5mm扫描对视神经乳头(ONH)进行成像。测试视野参数[平均偏差(MD)、模式标准偏差(PSD)和视野指数(VFI)]、布鲁赫膜开口最小边缘宽度(BMO-MRW)、视网膜神经纤维层厚度(RNFLT)以及立体测量参数边缘面积、杯盘面积(HRT III,海德堡视网膜断层扫描仪,海德堡工程公司)与血流密度数据的相关性。

结果

与对照组相比,青光眼组视网膜OCT血管造影(表层:p = 0.01;深层:p = 0.005)、视乳头周围放射状毛细血管网络(p < 0.001)以及视神经乳头OCT血管造影(p = 0.004)中的血流密度(全表面)显著降低。放射状视乳头周围毛细血管(RPC)网络中的血流密度与所有测试的功能和结构参数均显著相关。在RPC血流密度(视盘内)与BMO-MRW之间发现最强的相关性(斯皮尔曼相关系数 = 0.912,p < 0.001)。

结论

与健康对照相比,青光眼患者的视乳头和黄斑灌注减少。OCTA测量的血流密度与青光眼患者的结构损伤和视野缺损相关。使用OCTA对血流密度进行非侵入性定量分析提供了一个描述青光眼不同方面的新参数,这在临床实践中可能有用。

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