Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2018 Oct 30;8(1):16009. doi: 10.1038/s41598-018-34417-4.
In patients with glaucomatous parafoveal scotoma, evidence of compromised vascular circulation was commonly seen. The purpose of this study is to evaluate the relationship between macular vascular density (VD) and central visual function and structure in glaucoma patients. We enrolled 46 eyes of normal tension glaucoma (NTG) patients with parafoveal scotoma. All subjects underwent measurement of segmented macular thickness in each layer and optical coherence tomography angiography (OCTA) to assess VD of macula. Correlation coefficients of VD with structural parameters were identified and multivariate regression analyses were performed to verify factors affecting the MD of SITA 10-2. Superficial VD in NFL, GCL and IPL showed significant correlation with thickness of those layers, but deep VD in INL did not show meaningful correlation with any structural parameters. However, deep VD showed significant correlations with central visual field parameters such as MD of SITA 10-2. By multivariate regression analysis, the significant factors affecting central visual function were deep VD. Different multivariate regression models including segmented macular thicknesses were compared and R value was best for the model with deep VD, not containing superficial VD (R = 0.326, p = 0.001). Assigning subjects as worse or better visual functional group using regression line, deep VD of worse functional group was significantly lower than that of better group. In couclusion, decreased deep VD was an independent risk factor for central scotoma in addition to structural thinning. Taking both macular thickness and vascular circulation into acount, the deterioration of central visual function could be predicted more precisely.
在青光眼旁中心视野缺损患者中，常可见到血管循环受损的证据。本研究旨在评估青光眼患者黄斑血管密度（VD）与中心视觉功能和结构之间的关系。我们纳入了 46 例伴有旁中心视野缺损的正常眼压性青光眼（NTG）患者的 46 只眼。所有受试者均接受了分段黄斑厚度测量和光学相干断层扫描血管造影（OCTA），以评估黄斑 VD。确定了 VD 与结构参数的相关系数，并进行了多元回归分析，以验证影响 SITA 10-2 MD 的因素。NFL、GCL 和 IPL 的浅层 VD 与这些层的厚度有显著相关性，而 INL 的深层 VD 与任何结构参数均无显著相关性。然而，深层 VD 与 SITA 10-2 的中心视野参数如 MD 有显著相关性。通过多元回归分析，影响中心视觉功能的显著因素是深层 VD。比较了包括分段黄斑厚度在内的不同多元回归模型，发现仅包含深层 VD 的模型的 R 值最佳（R=0.326，p=0.001）。使用回归线将受试者分为视觉功能较差或较好的组，发现较差功能组的深层 VD 明显低于较好组。总之，与结构变薄相比，深层 VD 降低是中心暗点的独立危险因素。同时考虑黄斑厚度和血管循环，可以更准确地预测中心视觉功能的恶化。
