The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Invest Ophthalmol Vis Sci. 2019 Feb 1;60(2):838-842. doi: 10.1167/iovs.18-26115.
To explore the correlation between longitudinal changes of peripapillary retinal nerve fiber layer (RNFL) thickness and the presence of parapapillary choroidal microvasculature dropout (MvD).
This is a longitudinal cohort study. All patients with normal-tension glaucoma (NTG) were recruited from the Wenzhou Glaucoma Progression Study. The presence of MvD was determined using optical coherence tomography (OCT) angiography and the RNFL thickness was evaluated by spectral-domain OCT. All assessments were performed both at baseline and at every 3-month follow-up for at least 18 months.
Seventy-one eyes were included. The presence of MvD was observed in 23 NTG eyes (32.4%). Eyes with MvD had a thinner RNFL (68.8 ± 9.6 vs. 76.2 ± 16.7 μm, P = 0.016) and a faster rate of RNFL loss (-1.2 ± 1.5 vs. -0.4 ± 1.4 μm/y, P = 0.036) compared with those without MvD. In a univariate analysis of rates of RNFL loss, the presence of MvD at baseline (β = -0.83 ± 0.38, P = 0.033) was significantly associated with progressive RNFL loss. After adjusting for age, female sex, mean follow-up IOP, axial length, central corneal thickness, and mean deviation, the presence of MvD at baseline (β = -0.85 ± 0.41, P = 0.041) was significantly associated with faster rates of RNFL loss in the multivariate analysis.
There is a significant correlation between the presence of MvD and decrease in RNFL thickness in NTG patients. Our study further supported that the presence of MvD is a predictor of longitudinal RNFL damage in glaucoma.
探讨视盘旁视网膜神经纤维层（RNFL）厚度的纵向变化与视盘旁脉络膜微血管丢失（MvD）之间的相关性。
这是一项纵向队列研究。所有正常眼压性青光眼（NTG）患者均从温州青光眼进展研究中招募。使用光学相干断层扫描血管造影术（OCTA）确定 MvD 的存在，并用谱域 OCT 评估 RNFL 厚度。所有评估均在基线和至少 18 个月的每 3 个月随访时进行。
共纳入 71 只眼。23 只 NTG 眼中观察到 MvD（32.4%）。存在 MvD 的眼 RNFL 更薄（68.8 ± 9.6 μm 比 76.2 ± 16.7 μm，P = 0.016），RNFL 丢失速度更快（-1.2 ± 1.5 μm/y 比 -0.4 ± 1.4 μm/y，P = 0.036）。在 RNFL 丢失率的单变量分析中，基线时存在 MvD（β = -0.83 ± 0.38，P = 0.033）与进行性 RNFL 丢失显著相关。在校正年龄、女性、平均随访眼压、眼轴长度、中央角膜厚度和平均偏差后，基线时存在 MvD（β = -0.85 ± 0.41，P = 0.041）在多变量分析中与更快的 RNFL 丢失率显著相关。
在 NTG 患者中，MvD 的存在与 RNFL 厚度的减少之间存在显著相关性。我们的研究进一步支持 MvD 的存在是青光眼纵向 RNFL 损伤的预测因子。
