National Healthcare Group Eye Institute, Tan Tock Seng Hospital.
Institute for Infocomm Research, Agency for Science, Technology, and Research, Singapore, Singapore.
J Glaucoma. 2019 Jan;28(1):80-87. doi: 10.1097/IJG.0000000000001125.
To study the microvascular density of the macular and optic nerve head in healthy and glaucoma subjects using optical coherence tomography angiography.
We performed a cross-sectional cohort study on healthy subjects and patients with glaucoma. The AngioVue Enhanced Microvascular Imaging System was used to capture the optic nerve head and macula images during one visit. En face segment images of the macular and optic disc were studied in layers. Microvascular density of the optic nerve head and macula were quantified by the number of pixels measured by a novel in-house developed software. Areas under the receiver operating characteristic curves (AUROC) were used to determine the accuracy of differentiating between glaucoma and healthy subjects.
A total of 24 (32 eyes) glaucoma subjects (57.5±9.5-y old) and 29 (58 eyes) age-matched controls (51.17±13.5-y old) were recruited. Optic disc and macula scans were performed showing a greater mean vessel density (VD) in healthy compared with glaucoma subjects. The control group had higher VD than the glaucoma group at the en face segmented layers of the optic disc (optic nerve head: 0.209±0.05 vs. 0.110±0.048, P<0.001; vitreoretinal interface: 0.086±0.045 vs. 0.052±0.034, P=0.001; radial peripapillary capillary: 0.146±0.040 vs. 0.053±0.036, P<0.001; and choroid: 0.228±0.074 vs. 0.165±0.062, P<0.001). Similarly, the VD at the macula was also greater in controls than glaucoma patients (superficial retina capillary plexus: 0.115±0.016 vs. 0.088±0.027, P<0.001; deep retina capillary plexus: 0.233±0.027 vs. 0.136±0.073, P<0.001; outer retinal capillary plexus: 0.190±0.057 vs. 0.136±0.105, P=0.036; and choriocapillaris: 0.225±0.053 vs. 0.153±0.068, P<0.001. The AUROC was highest for optic disc radial peripapillary capillary (0.96), followed by nerve head (0.92) and optic disc choroid (0.76). At the macula, the AUROC was highest for deep retina (0.86), followed by choroid (0.84), superficial retina (0.81), and outer retina (0.72).
Microvascular density of the optic disc and macula in glaucoma patients was reduced compared with healthy controls. VD of both optic disc and macula had a high diagnostic ability in differentiating healthy and glaucoma eyes.
使用光相干断层扫描血管造影术研究健康人和青光眼患者的黄斑和视神经头的微血管密度。
我们对健康受试者和青光眼患者进行了横断面队列研究。在一次就诊期间，使用 AngioVue 增强微血管成像系统捕获视神经头和黄斑图像。在分层中研究了黄斑和视盘的层间平面节段图像。通过我们新开发的软件测量的像素数来量化视神经头和黄斑的微血管密度。使用接收器操作特征曲线下的面积 (AUROC) 来确定区分青光眼和健康受试者的准确性。
共招募了 24 名（32 只眼）青光眼患者（57.5±9.5 岁）和 29 名（58 只眼）年龄匹配的对照组（51.17±13.5 岁）。进行视盘和黄斑扫描显示，与青光眼患者相比，健康对照组的平均血管密度（VD）更高。与青光眼组相比，对照组在视盘的平面分割层具有更高的 VD（视神经头：0.209±0.05 与 0.110±0.048，P<0.001；玻璃体视网膜界面：0.086±0.045 与 0.052±0.034，P=0.001；视盘周围毛细血管：0.146±0.040 与 0.053±0.036，P<0.001；脉络膜：0.228±0.074 与 0.165±0.062，P<0.001）。同样，与青光眼患者相比，黄斑的 VD 也更高（浅层视网膜毛细血管丛：0.115±0.016 与 0.088±0.027，P<0.001；深层视网膜毛细血管丛：0.233±0.027 与 0.136±0.073，P<0.001；外层视网膜毛细血管丛：0.190±0.057 与 0.136±0.105，P=0.036；脉络膜：0.225±0.053 与 0.153±0.068，P<0.001）。视盘周围毛细血管的 AUROC 最高（0.96），其次是视神经头（0.92）和视盘脉络膜（0.76）。在黄斑中，深层视网膜的 AUROC 最高（0.86），其次是脉络膜（0.84）、浅层视网膜（0.81）和外层视网膜（0.72）。
与健康对照组相比，青光眼患者的视神经头和黄斑的微血管密度降低。视盘和黄斑的 VD 在区分健康和青光眼眼方面具有很高的诊断能力。
