Department of Ophthalmology, Peking University First Hospital, 8 Xi Shi Ku Street, Xi Cheng District, Beijing, 100034, People's Republic of China.
BMC Ophthalmol. 2019 Oct 7;19(1):203. doi: 10.1186/s12886-019-1211-1.
Glaucoma, an important cause of visual impairment in many countries, remains a common eye condition due to difficulties in its early diagnosis. We analyzed the characteristics of retinal arteries to add a valuable technology for helping the normal tension glaucoma (NTG) diagnosis.
This study included 51 patients with newly diagnosed NTG with hemifield defects and 60 age-matched controls. Peripapillary retinal arteriolar calibers (PRACs) photoed by non-mydriatic retinal camera were measured using ImageJ by two masked readers. We also performed spectral-domain optical coherence tomography to evaluate retinal nerve fiber layer thickness (RNFLT) and optic disc parameters. Their relations to retinal arteriolar calibers were investigated by univariate and multivariate linear regression. The area under the receiver operating characteristic curve (AUROC) was used to confirm the powers to detect NTG by PRACs.
PRACs in four quadrants were significantly reduced in individuals with first diagnosed NTG (82 ± 15.1 μm, 80 ± 13.6 μm, 71 ± 11.6 μm, and 64 ± 10.0 μm) compared with those in age-matched controls (101 ± 9.8 μm, 105 ± 8.7 μm, 90 ± 7.5 μm, and 82 ± 9.8 μm). Superotemporal and inferotemporal PRACs in the visual field-affected hemifield were narrower than those in the unaffected hemifield in NTG group (P ≤ 0.004). Temporal PRACs in the RNFL unaffected hemifield were significantly narrower than in healthy eyes (P < 0.001). Superotemporal PRAC showed a significant correlation with superior RNFLT (β = 0.659, P < 0.001), and a similar relationship was found between inferotemporal PRAC and inferior RNFLT (β = 0.227, P = 0.015). The diagnostic capability of temporal PRACs was satisfactory (superotemporal PRAC; AUROC 0.983, cut-off value 84.7 μm, inferotemporal PRAC; AUROC 0.946, cut-off value 94.2 μm).
PRAC and inferotemporal PRAC are valid parameters for discriminating patients with NTG.
青光眼是许多国家导致视力损害的重要原因，由于其早期诊断困难，仍然是一种常见的眼部疾病。我们分析了视网膜动脉的特征，以增加一种有价值的技术来帮助正常眼压青光眼（NTG）的诊断。
本研究纳入了 51 例初诊 NTG 伴视野缺损患者和 60 例年龄匹配的对照组。使用非散瞳视网膜照相机拍摄视盘周围视网膜小动脉（PRAC），由两位盲法读者使用 ImageJ 进行测量。我们还进行了频域光相干断层扫描（OCT）以评估视网膜神经纤维层厚度（RNFLT）和视盘参数。通过单变量和多变量线性回归分析它们与视网膜小动脉直径的关系。采用受试者工作特征曲线（ROC）下面积（AUROC）来确认 PRAC 检测 NTG 的效能。
与年龄匹配的对照组相比，初次诊断为 NTG 的个体的四个象限的 PRAC 明显变窄（82 ± 15.1μm，80 ± 13.6μm，71 ± 11.6μm，64 ± 10.0μm）（101 ± 9.8μm，105 ± 8.7μm，90 ± 7.5μm，82 ± 9.8μm）。NTG 组视野受累半视野的上方和下方颞侧 PRAC 比未受累半视野的更窄（P ≤ 0.004）。不受 RNFL 影响的半视野的颞侧 PRAC 明显比健康眼更窄（P < 0.001）。上方颞侧 PRAC 与上方 RNFLT 呈显著相关性（β = 0.659，P < 0.001），下方颞侧 PRAC 与下方 RNFLT 也存在类似的关系（β = 0.227，P = 0.015）。颞侧 PRAC 的诊断能力令人满意（上方颞侧 PRAC；AUROC 0.983，截断值 84.7μm，下方颞侧 PRAC；AUROC 0.946，截断值 94.2μm）。
PRAC 和下方颞侧 PRAC 是鉴别 NTG 患者的有效参数。
