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小梁切除术后6个月通过光学相干断层扫描血管造影术测量的视网膜灌注。

Retinal perfusion 6 months after trabeculectomy as measured by optical coherence tomography angiography.

作者信息

Lommatzsch C, Rothaus K, Koch J M, Heinz C, Grisanti S

机构信息

Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.

Department of Ophthalmology, University of Essen, Duisburg, Germany.

出版信息

Int Ophthalmol. 2019 Nov;39(11):2583-2594. doi: 10.1007/s10792-019-01107-7. Epub 2019 May 9.

Abstract

PURPOSE

To investigate potential changes of vessel density (VD) at the optic nerve head (ONH) and the macula 6 months after trabeculectomy (TE).

METHODS

In a prospective monocentric study, 19 eyes with open-angle glaucoma were treated with TE + MMC (mitomycin C). At four different time points multiple morphological papillary parameters were measured by OCT, and the ONH VD in the radial peripapillary capillary layer and the superficial and deep plexuses of the macula was determined by OCTA (optical coherence tomography angiography, RTVue-XR, Optovue). The mean defect was determined by visual field examination (mode 30-2, Humphrey Field Analyzer). The duration of follow-up was 6 months.

RESULTS

Nineteen eyes, one each from 19 patients (11 females; 8 males) with a mean age of 66.0 (58.07, 70.94) years and a mean intraocular pressure (IOP) of 21.0 mmHg (17.07, 23.87), were included in the study. All showed a significant reduction in IOP at each follow-up after TE (p < 0.0001). There was no significant change in the peripapillary retinal nerve fiber layer thickness (p = 0.88), the ganglion cell complex (p = 0.97), the cup-disk ratio (p = 0.63), the rim area (p = 0.78), or the mean visual field defect (p = 0.82). With regard to VD, no significant difference could be determined in either the ONH or the macular area.

CONCLUSIONS

After significant surgical reduction of IOP by TE, there are no significant detectable morphological changes in the ONH or the ganglion cell complex as measured by OCT, nor does the papillary or macular OCTA-determined VD change significantly. Trial registration 2016-409-f-S Avanti-OCT-A. Registered December 1, 2016.

摘要

目的

研究小梁切除术(TE)6个月后视神经乳头(ONH)和黄斑区血管密度(VD)的潜在变化。

方法

在一项前瞻性单中心研究中,对19例开角型青光眼患者的眼睛进行小梁切除术联合丝裂霉素C(MMC)治疗。在四个不同时间点,通过光学相干断层扫描(OCT)测量多个形态学乳头参数,并通过光学相干断层扫描血管造影(OCTA,RTVue-XR,Optovue)测定ONH在放射状视乳头周围毛细血管层以及黄斑区浅层和深层神经丛中的VD。通过视野检查(模式30-2,Humphrey视野分析仪)确定平均缺损。随访时间为6个月。

结果

本研究纳入了19例患者的19只眼睛(11例女性;8例男性),平均年龄为66.0(58.07,70.94)岁,平均眼压(IOP)为21.0 mmHg(17.07,23.87)。所有患者在小梁切除术后的每次随访中眼压均显著降低(p < 0.0001)。视乳头周围视网膜神经纤维层厚度(p = 0.88)、神经节细胞复合体(p = 0.97)、杯盘比(p = 0.63)、边缘面积(p = 0.78)或平均视野缺损(p = 0.82)均无显著变化。关于VD,在ONH或黄斑区均未发现显著差异。

结论

小梁切除术显著降低眼压后,通过OCT测量,ONH或神经节细胞复合体未发现明显的形态学变化,视乳头或黄斑区OCTA测定的VD也未发生显著改变。试验注册号:2016-409-f-S Avanti-OCT-A。于2016年12月1日注册。

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