Lommatzsch C, Rothaus K, Koch J M, Heinz C, Grisanti S
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.
Department of Ophthalmology, University of Essen, Essen, Germany.
Graefes Arch Clin Exp Ophthalmol. 2018 Aug;256(8):1499-1508. doi: 10.1007/s00417-018-3965-1. Epub 2018 Apr 10.
To evaluate whether macular optical coherence tomography angiography (OCTA) can detect altered vessel density (VD) in the superficial and deep vascular plexus in glaucomatous eyes and to compare the diagnostic utility of the individual VD parameters.
The macular VD of 135 eyes, comprising 85 eyes diagnosed with glaucoma and 50 healthy control eyes, was examined using two OCTA devices (AngioPlex-Zeiss Meditec, Inc., Dublin, CA, USA, and AngioVue-OptoVue, Inc., Fremont, CA, USA). All study participants had neither vascular pathology, diabetes, nor vasoactive medication. The macular VD was measured at two different levels of segmentation (superficial [SL] and deep [DL] retinal vascular plexus) with a 6 × 6-mm macula scan, and VD was correlated with various structural and functional measurements. In order to test the accuracy of differentiation between eyes with and without glaucoma, we calculated the receiver operating characteristic (ROC) curve and the area under the curve (AUC).
Macular VD was significantly lower in both SL and DL in glaucomatous eyes than in healthy eyes (p = SL < 0.0001; DL = 0.009). There was no significant difference in VD between the SL and the DL (p = 6.60 · 10). The greatest reduction of VD in glaucomatous eyes was found in the inferior macular sector. There was no correlation of VD with age or refractive error but moderate to high correlation with intraocular pressure, time of initial diagnosis, mean deviation, ganglion cell complex, peripapillary retinal nerve fiber layer thickness, cup to disc ratio, and rim area. Among the 14 individual features of macular VD, whole VD in the SL had the best diagnostic accuracy (77.6%) as measured by the area under the ROC.
OCTA detects glaucomatous damage by measuring the macular vessel density in the superficial and deep retinal vascular plexus. It can be an additional diagnostic tool to detect glaucoma independently of the optic nerve.
评估黄斑光学相干断层扫描血管造影（OCTA）能否检测青光眼患者眼内浅表和深部血管丛中血管密度（VD）的改变，并比较各个VD参数的诊断效用。
使用两台OCTA设备（美国加利福尼亚州都柏林市蔡司医疗技术公司的AngioPlex和美国加利福尼亚州弗里蒙特市OptoVue公司的AngioVue）对135只眼睛的黄斑VD进行检查，其中包括85只诊断为青光眼的眼睛和50只健康对照眼。所有研究参与者均无血管病变、糖尿病或使用血管活性药物。通过6×6mm黄斑扫描在两个不同的分割水平（浅表[SL]和深部[DL]视网膜血管丛）测量黄斑VD，并将VD与各种结构和功能测量值进行关联。为了测试区分有无青光眼的眼睛的准确性，我们计算了受试者工作特征（ROC）曲线和曲线下面积（AUC）。
青光眼患者眼内SL和DL的黄斑VD均显著低于健康眼（p = SL < 0.0001；DL = 0.009）。SL和DL之间的VD无显著差异（p = 6.60·10）。青光眼患者眼内黄斑VD降低最明显的区域是黄斑下象限。VD与年龄或屈光不正无相关性，但与眼压、初次诊断时间、平均偏差、神经节细胞复合体、视乳头周围视网膜神经纤维层厚度、杯盘比和边缘面积呈中度至高度相关。在黄斑VD的14个个体特征中，SL中的全VD通过ROC曲线下面积测量具有最佳诊断准确性（77.6%）。
OCTA通过测量视网膜浅表和深部血管丛中的黄斑血管密度来检测青光眼损害。它可以作为一种独立于视神经检测青光眼的额外诊断工具。
