Department of Ophthalmology, Jena University Hospital, Jena, Germany.
Invest Ophthalmol Vis Sci. 2019 Apr 1;60(5):1309-1315. doi: 10.1167/iovs.18-26099.
Reduced perfusion of the retinal parapapillary tissue is well documented in glaucoma patients. Whether or not this is a cause or result of the disease is however unknown. Studying the correlation of this perfusion and the retinal vascular oxygen saturation (O2S) could give clues to the retinal O2 consumption/demand and provide an answer to this question.
Seventeen eyes of 17 healthy controls and 32 eyes of 32 patients with primary open angle glaucoma were prospectively recruited. Global and sectoral nerve fiber layer (NFL) thickness was measured with optical coherence tomography (OCT); parapapillary OCT-angiography was performed and quantified into vascular density (VD) and perfusion density (PD). Retinal vascular O2S was measured.
Global and sectoral NFL thickness, VD, PD (except for temporal sector of VD), and arteriovenous difference of O2S (AV-D) were lower in glaucomatous eyes compared with controls (P < 0.05 for all). A significant inverse correlation of venous O2S with global VD (r = -0.37, P = 0.04) and PD (r = -0.37, P = 0.04) and a direct correlation of the AV-D with global VD (r = 0.50, P = 0.004) and PD (r = 0.49, P = 0.004) were observed. In sector analysis, the strongest correlation of AV-D with VD and PD was seen in inferior (VD: r = 0.52, P = 0.001; PD: r = 0.55, P = 0.002) and superior (VD: r = 0.454, P = 0.009; PD: r = 0.46, P = 0.008) segments.
In glaucomatous eyes, there exists a direct correlation of the AV-D to the VD and PD with the strongest correlation being in superior and inferior segments where typically tissue loss occurs. This could possibly be explained by the loss of tissue being followed by the reduced density.
已有研究证明,青光眼患者的视网膜旁组织灌注减少。但目前尚不清楚这种灌注减少是疾病的原因还是结果。研究这种灌注与视网膜血管氧饱和度(O2S)之间的相关性,可以为视网膜的氧消耗/需求提供线索,并回答这个问题。
前瞻性招募了 17 名健康对照者的 17 只眼和 32 名原发性开角型青光眼患者的 32 只眼。采用光学相干断层扫描(OCT)测量全层和节段神经纤维层(NFL)厚度;进行视网膜旁 OCT 血管造影检查,并将其量化为血管密度(VD)和灌注密度(PD)。测量视网膜血管 O2S。
与对照组相比,青光眼患者的全层和节段性 NFL 厚度、VD、PD(除颞区外)和 O2S 的动静脉差(AV-D)均较低(所有 P 值均<0.05)。静脉 O2S 与全层 VD(r=-0.37,P=0.04)和 PD(r=-0.37,P=0.04)呈显著负相关,而 AV-D 与全层 VD(r=0.50,P=0.004)和 PD(r=0.49,P=0.004)呈直接正相关。在节段分析中,AV-D 与 VD 和 PD 的相关性最强的是下方(VD:r=0.52,P=0.001;PD:r=0.55,P=0.002)和上方(VD:r=0.454,P=0.009;PD:r=0.46,P=0.008)节段。
在青光眼患者中,AV-D 与 VD 和 PD 呈直接相关,最强的相关性出现在通常发生组织丢失的上方和下方节段。这可能是由于组织丢失后密度降低所致。