使用不同的视野严重程度分类系统评估开角型青光眼患者的黄斑血管微循环。
Macular Vascular Microcirculation in Eyes With Open-angle Glaucoma Using Different Visual Field Severity Classification Systems.
机构信息
Departments of Ophthalmology.
Bioengineering, University of Washington, Seattle, WA.
出版信息
J Glaucoma. 2019 Sep;28(9):790-796. doi: 10.1097/IJG.0000000000001308.
PRECIS
We found significant differences in macular vascular microcirculation between normal and glaucomatous eyes using optical coherence tomography angiography (OCTA). Macular vascular microcirculation changes also showed significant correlations with visual field (VF) severity classification systems.
PURPOSE
To correlate VF severity defined by different classification systems and macular vascular microcirculation in eyes with glaucoma using OCTA.
PATIENTS AND METHODS
Twenty normal and 58 open-angle glaucoma (OAG) eyes were scanned using a swept-source OCTA (Plex Elite 9000) and macular vascular microcirculation was measured by calculating the overall blood flux index (BFI) and vessel area density (VAD) over the entire 6×6 mm area excluding the big retinal vessels. Glaucomatous eyes were staged into severity groups based on 4 VF severity classifications: Hodapp-Parrish-Anderson scale, Glaucoma Severity Staging system, ICD-10 glaucoma staging definitions, and VF mean deviation. Central 10-degree VF mean sensitivity (CMS) was calculated based on 24-2 VF. One-way analysis of variance was used to analyze the differences and correlation between macular vascular microcirculation and other clinical parameters.
RESULTS
Glaucomatous eyes had significantly lower ganglion cell and inner plexiform layer BFI and VAD (P<0.0001) compared with normal eyes. In OAG patients, BFI and VAD were significantly higher in mild OAG compared with severe OAG with all VF disease severity classification systems (P<0.001). Glaucoma Severity Staging had the highest correlation with changes in macular vascular microcirculation metrics (r=0.734 for BFI; r=0.647 for VAD) and VF CMS had highest correlation with macular vascular microcirculation metrics (r=0.887 for BFI; r=0.903 for VAD).
CONCLUSION
Macular vascular microcirculation metrics detected by OCTA correlate with disease severity in glaucomatous eyes. VF CMS, calculated from only 12 tested central 10-degree points, correlated best with macular OCTA.
摘要
我们使用光相干断层扫描血管造影术（OCTA）发现正常眼和青光眼眼中黄斑血管微循环存在显著差异。黄斑血管微循环变化也与视野（VF）严重程度分类系统有显著相关性。
目的
使用 OCTA 分析不同分类系统定义的 VF 严重程度与青光眼眼中黄斑血管微循环的关系。
患者和方法
使用扫频源 OCTA（Plex Elite 9000）对 20 只正常眼和 58 只开角型青光眼（OAG）眼进行扫描，并通过计算整个 6×6mm 区域（排除大视网膜血管）的整体血流通量指数（BFI）和血管面积密度（VAD）来测量黄斑血管微循环。根据 4 种 VF 严重程度分类（Hodapp-Parrish-Anderson 量表、青光眼严重程度分期系统、ICD-10 青光眼分期定义和 VF 平均偏差）将青光眼眼分为严重程度组。根据 24-2 VF 计算中央 10 度 VF 平均敏感度（CMS）。采用单因素方差分析比较黄斑血管微循环与其他临床参数之间的差异和相关性。
结果
与正常眼相比，青光眼眼的神经节细胞和内丛状层 BFI 和 VAD 显著降低（P<0.0001）。在 OAG 患者中，与所有 VF 疾病严重程度分类系统相比，轻度 OAG 的 BFI 和 VAD 均显著高于重度 OAG（P<0.001）。青光眼严重程度分期与黄斑血管微循环指标变化相关性最高（BFI 的 r 值为 0.734；VAD 的 r 值为 0.647），VF CMS 与黄斑血管微循环指标相关性最高（BFI 的 r 值为 0.887；VAD 的 r 值为 0.903）。
结论
OCTA 检测的黄斑血管微循环指标与青光眼眼中的疾病严重程度相关。仅从 12 个测试的中央 10 度点计算得出的 VF CMS 与黄斑 OCTA 相关性最佳。
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