高级青光眼患者黄斑和视盘周围微血管与视野敏感性的相关性研究。
Association of Macular and Circumpapillary Microvasculature with Visual Field Sensitivity in Advanced Glaucoma.
机构信息
Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA; Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan.
出版信息
Am J Ophthalmol. 2019 Aug;204:51-61. doi: 10.1016/j.ajo.2019.03.004. Epub 2019 Mar 14.
PURPOSE
To evaluate the association between optical coherence tomography angiography (OCTA) macular and circumpapillary vessel density and visual field mean deviation (MD) in advanced primary open angle glaucoma.
DESIGN
Cross-sectional study.
METHODS
Macula (superficial layer) and optic nerve head (ONH) with capillary density (CD) and without vessel density (VD) automated removal of large vessels OCTA of 34 eyes (34 patients, MD < -10 dB) were investigated as macula whole image VD (wiVD), parafoveal VD (pfVD), ONH wiVD, wiCD, circumpapillary VD, and cpCD. Spectral domain OCT circumpapillary retinal nerve fiber layer, macular ganglion cell complex, and ganglion cell inner plexiform layer were also analyzed.
RESULTS
Macular and ONH VD decreased significantly with worsening MD. Each 1-dB decrease in MD was associated with a reduction of 0.43% and 0.46% for macular wiVD and pfVD with R of 0.28 and 0.27, respectively (all P < .01). The association between MD and VD was strongest for measures of ONH with large vessels removed, wiCD, and cpCD, followed by wiVD and circumpapillary VD with R of 0.26, 0.22, 0.17, 0.14, and a VD reduction of 0.43%, 0.51%, 0.33%, and 0.40%, respectively (all P < .02). There was a reduction of 1.19 μm in Avanti parafoveal ganglion cell complex, 1.13 μm in Spectralis ganglion cell inner plexiform layer, and 1.01 μm in Spectralis circumpapillary retinal nerve fiber layer, with R of 0.19 (P = .006), 0.23 (P = .002), and 0.24 (P = .002), respectively.
CONCLUSIONS
ONH and macula OCTA VD and thickness are associated with the severity of visual field damage in advanced primary open angle glaucoma.
目的
评估光学相干断层扫描血管造影（OCTA）黄斑和环视盘血管密度与晚期原发性开角型青光眼视野平均偏差（MD）之间的关系。
设计
横断面研究。
方法
对 34 只眼（34 例患者，MD < -10dB）的 OCTA 进行了黄斑（浅层）和视神经头（ONH）的毛细血管密度（CD）和无血管密度（VD）自动去除大血管的检测，包括黄斑全像 VD（wiVD）、旁中心凹 VD（pfVD）、ONH wiVD、wiCD、环视盘 VD 和 cpCD。还分析了光谱域 OCT 环视盘视网膜神经纤维层、黄斑神经节细胞复合体和神经节细胞内丛状层。
结果
黄斑和 ONH VD 随 MD 的恶化而显著下降。MD 每降低 1dB，黄斑 wiVD 和 pfVD 分别减少 0.43%和 0.46%，相关系数 R 分别为 0.28 和 0.27（均 P <.01）。与保留大血管的 ONH 测量值 wiCD 和 cpCD 相比，MD 与 VD 的相关性最强，其次是 wiVD 和环视盘 VD，相关系数 R 分别为 0.26、0.22、0.17、0.14，VD 分别减少 0.43%、0.51%、0.33%和 0.40%（均 P <.02）。Avanti 旁中心凹神经节细胞复合体减少 1.19μm，Spectralis 神经节细胞内丛状层减少 1.13μm，Spectralis 环视盘视网膜神经纤维层减少 1.01μm，相关系数 R 分别为 0.19（P =.006）、0.23（P =.002）和 0.24（P =.002）。
结论
晚期原发性开角型青光眼，OCTA 视神经头和黄斑 VD 和厚度与视野损害的严重程度相关。
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