Shin Jonghoon, Kwon Jeong Min, Park Su Hwan, Seo Je Hyun, Jung Jae Ho
Department of Ophthalmology, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Transl Vis Sci Technol. 2019 Jul 30;8(4):12. doi: 10.1167/tvst.8.4.12. eCollection 2019 Jul.
The purpose of this study was to analyze the macular vessel density layer-by-layer and compare the diagnostic value of each in diagnosing glaucoma.
This was a prospective comparative cross-sectional study, and the setting was glaucoma referral practice. The study participants were patients with primary open-angle glaucoma undergoing treatment with drugs, and age-matched normal controls who visited our clinic for regular eye examinations for refractive errors. All participants were investigated using macular optical coherence tomographic angiography, fundus photography, and 24-2 visual field (VF) testing. Average vessel densities in the retinal nerve fiber-ganglion cell-inner plexiform layer (IPL), retinal nerve fiber-ganglion cell layer (GCL), retinal nerve fiber layer (RNFL), ganglion cell-IPL, GCL, and IPL segments on optical coherence tomographic angiography.
Fifty-eight glaucomatous eyes of 58 participants and 52 healthy eyes of 52 normal subjects were included in the study. The average vessel densities of all segments, except the RNFL in the glaucoma group, were significantly lower than that in normal subjects. The average vessel density in the ganglion cell-IPL showed the highest correlation with the mean deviation and VF index of the VF ( = 0.515 and 0.538, respectively) and the best area under receiver operating characteristic curve to discriminate between patients with glaucoma and patients with normal eyes (0.750).
The present study demonstrated that macular vessel density in the ganglion cell-IPL has a higher diagnostic ability and better correlation with functional damage in glaucoma than that in the superficial vascular plexus.
These findings suggest that the macular vessel density in the ganglion cell-inner plexiform layer is better than that in the conventional superficial vascular plexus for detecting glaucoma.
本研究旨在逐层分析黄斑血管密度，并比较其在青光眼诊断中的诊断价值。
这是一项前瞻性比较横断面研究，研究地点为青光眼转诊诊所。研究参与者为正在接受药物治疗的原发性开角型青光眼患者，以及因屈光不正来我院进行常规眼部检查的年龄匹配的正常对照者。所有参与者均接受黄斑光学相干断层扫描血管造影、眼底照相和24-2视野（VF）测试。光学相干断层扫描血管造影上视网膜神经纤维-神经节细胞-内丛状层（IPL）、视网膜神经纤维-神经节细胞层（GCL）、视网膜神经纤维层（RNFL）、神经节细胞-IPL、GCL和IPL节段的平均血管密度。
本研究纳入了58名参与者的58只青光眼眼和52名正常受试者的52只健康眼。除青光眼组的RNFL外，所有节段的平均血管密度均显著低于正常受试者。神经节细胞-IPL中的平均血管密度与VF的平均偏差和VF指数的相关性最高（分别为r = 0.515和0.538），并且在区分青光眼患者和正常眼患者方面，其受试者操作特征曲线下面积最大（0.750）。
本研究表明，与浅表血管丛相比，神经节细胞-IPL中的黄斑血管密度在青光眼诊断中具有更高的诊断能力，并且与功能损害的相关性更好。
这些发现表明，神经节细胞-内丛状层中的黄斑血管密度在检测青光眼方面优于传统的浅表血管丛。
