Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, La Jolla, CA.
Department of Ophthalmology, Saitama Medical University, Saitama.
J Glaucoma. 2018 Jun;27(6):481-489. doi: 10.1097/IJG.0000000000000964.
To evaluate the association between macula vascular density assessed by optical coherence tomography angiography (OCT-A) and central visual field (VF) threshold sensitivities in healthy, glaucoma suspect, and glaucoma patients.
A total of 185 eyes from 38 healthy participants, 31 glaucoma suspects, 72 mild glaucoma patients, and 44 moderate/severe glaucoma patients from the Diagnostic Innovations in Glaucoma Study who underwent OCT-A images of the macula and 10-2 VF testing were enrolled in this observational cross-sectional study. The relationship between central VF mean sensitivity (MS) and superficial macula whole-image vessel density (wiVD), and the relationship between the MS of the 4 central points of the 10-2 VF (MS4) and parafoveal vessel density (pfVD), were assessed using linear regression models.
Mean wiVD (52.5%, 49.8%, 49.4% and 45.2%, respectively) and mean pfVD (54.9%, 52.1%, 51.8% and 47.7%, respectively) were found to be significantly higher in healthy eyes and glaucoma suspect eyes compared with glaucoma eyes with mild and moderate/severe disease [analysis of covariance (ANCOVA) P<0.001]. The univariate associations between 10-2 MS and wiVD (R=26.9%) and between 10-2 MS4 and pfVD (R=16.8%) were statistically significant (P<0.001 for both). After adjusting for scan quality, age, sex and intraocular pressure, superficial macula wiVD and pfVD were still independently associated with central VF loss. Macula wiVD performed better [area under the receiver operator characteristic (AUROC)=0.70] than ganglion cell complex thickness (AUROC=0.50) for differentiating between glaucoma suspect and healthy eyes (P=0.010).
Loss of OCT-A macula vessel density is associated with central 10-2 VF defects. Macula vessel density is a clinically relevant parameter that may enhance monitoring of glaucoma suspects and patients.
评估光学相干断层扫描血管造影术（OCT-A）评估的黄斑血管密度与健康者、青光眼疑似患者和青光眼患者的中心视野（VF）阈值敏感性之间的关系。
本观察性横断面研究共纳入 38 名健康参与者、31 名青光眼疑似患者、72 名轻度青光眼患者和 44 名中重度青光眼患者的 185 只眼，这些患者均接受了黄斑 OCT-A 图像和 10-2 VF 检查。使用线性回归模型评估中心 VF 平均敏感度（MS）与黄斑浅层整体图像血管密度（wiVD）之间的关系，以及 10-2 VF 中心 4 个点的 MS（MS4）与旁中心血管密度（pfVD）之间的关系。
健康眼和青光眼疑似眼的平均 wiVD（分别为 52.5%、49.8%、49.4%和 45.2%）和平均 pfVD（分别为 54.9%、52.1%、51.8%和 47.7%）均显著高于轻度和中重度疾病的青光眼眼[协方差分析（ANCOVA）P<0.001]。10-2 MS 与 wiVD 之间（R=26.9%）和 10-2 MS4 与 pfVD 之间（R=16.8%）的单变量关联具有统计学意义（两者 P<0.001）。调整扫描质量、年龄、性别和眼内压后，浅层黄斑 wiVD 和 pfVD 仍与中心 VF 损失独立相关。黄斑 wiVD 用于区分青光眼疑似患者和健康者的效果优于神经节细胞复合体厚度（AUROC=0.50）[AUROC=0.70，P=0.010]。
OCT-A 黄斑血管密度的丧失与中心 10-2 VF 缺陷相关。黄斑血管密度是一个与临床相关的参数，可能增强对青光眼疑似患者和患者的监测。
