Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
J Glaucoma. 2018 Jun;27(6):543-551. doi: 10.1097/IJG.0000000000000961.
To compare the visual field (VF) sensitivity according to the presence of parapapillary deep-layer microvasculature dropout (MvD_P) and focal lamina cribrosa (LC) defect.
Among 158 open-angle glaucoma patients, 4 groups were formed according to the presence of MvD_P and focal LC defect determined by optical coherence tomography (OCT) angiography and by enhanced depth imaging spectral-domain OCT, respectively: (1) eyes without either focal LC defect or MvD_P (group 1); (2) eyes with focal LC defect but no MvD_P (group 2); (3) eyes without focal LC defect but with MvD_P (group 3); (4) eyes with both focal LC defect and MvD_P (group 4). VF sensitivity and retinal nerve fiber layer (RNFL) thickness were compared among the 4 groups for global area and 6 sectors.
Both RNFL thickness and VF sensitivity differed among the 4 groups in all areas other than the nasal and superonasal sectors for RNFL thickness. On post hoc analysis, eyes with MvD_P (groups 3 and 4) had significantly worse VF sensitivity than group 2 [P<0.05, 1-way analysis of variance (ANOVA)] in all areas except the superotemporal and temporal sectors, whereas the RNFL thicknesses did not differ (P>0.05, 1-way ANOVA) in any areas except the superotemporal sector.
Eyes with MvD_P had worse VF sensitivity than those without MvD_P, and VF difference was more distinguished than differences of axonal loss and focal LC change. Further studies on the temporal relationship between the MvD_P and glaucomatous VF progression are warranted.
比较存在视盘旁深层微血管丢失(MvD_P)和局灶性筛板(LC)缺陷的视野(VF)敏感性。
在 158 例开角型青光眼患者中,根据光学相干断层扫描(OCT)血管造影和增强深度成像光谱域 OCT 分别确定的 MvD_P 和局灶性 LC 缺陷的存在,将患者分为 4 组:(1)既无局灶性 LC 缺陷也无 MvD_P 的眼(组 1);(2)有局灶性 LC 缺陷但无 MvD_P 的眼(组 2);(3)无局灶性 LC 缺陷但有 MvD_P 的眼(组 3);(4)既有局灶性 LC 缺陷也有 MvD_P 的眼(组 4)。比较 4 组患者在整个区域和 6 个扇区的 VF 敏感性和视网膜神经纤维层(RNFL)厚度。
除鼻侧和鼻上象限的 RNFL 厚度外,4 组患者在所有区域的 RNFL 厚度和 VF 敏感性均存在差异。在事后分析中,除颞上和颞下象限外,MvD_P 眼(组 3 和组 4)的 VF 敏感性明显低于组 2(P<0.05,单因素方差分析(ANOVA)),而在所有区域的 RNFL 厚度均无差异(P>0.05,单因素 ANOVA),除了颞上象限。
有 MvD_P 的眼的 VF 敏感性比没有 MvD_P 的眼差,VF 差异比轴突丢失和局灶性 LC 变化的差异更明显。需要进一步研究 MvD_P 与青光眼 VF 进展之间的时间关系。