Department of Ophthalmology, The People's Hospital of Leshan, Leshan, Sichuan Province, China.
PLoS One. 2020 Jun 25;15(6):e0234816. doi: 10.1371/journal.pone.0234816. eCollection 2020.
To compare the retinal vessel density and glaucomatous parameters in primary angle closure glaucoma (PACG), to evaluate the diagnostic and monitoring abilities of the peripapillary and macular vessel density in the progression of glaucoma.
This was a observational, prospective and cross-sectional study. According to Glaucoma Staging System, 218 eyes (116 participants) were divided into 5 groups: no glaucoma, early glaucoma, moderate glaucoma, advance glaucoma, severe glaucoma. All participants underwent a comprehensive ocular examination, which included corrected distance visual acuity measurement, slit-lamp biomicroscopy, intra ocular pressure (IOP), gonioscopy, fundus examination, stereoscopic optic disc photography, Humphrey visual field test(VF), peripapillary and macular optical coherence tomography angiography(OCTA) scan. SPSS software was used to calculate and compare retinal vessel density (peripapillary vessel density, PVD and macular vessel density, MVD) and glaucomatous parameters (mean deviation (MD),pattern standard deviation(PSD), retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer(GCIPL),rim area, average cup/disc(C/D) ratio).
The GCIPL thickness, RNFL thickness, PVD and MVD are significantly reduced in PACG. There were significant differences in all measurements among the groups (P<0.01).Reduced peripapillary and macular vessel density in glaucoma were detected and a statistically significant correlation with glaucoma stages (P<0.01). In addition, the results of retinal vessel density, reduced RNFL thickness and GCIPL thickness were also statistically related to the stage of glaucoma. As expected, the rim area was significantly smaller with higher C/D area ratios in glaucomatous eyes corresponding to the severity of disease.
The changes of PVD and MVD had strongly positive correlation with GCIPL thickness and RNFL thickness, had negative correlation with the severity of glaucoma, which meant the more severe the glaucoma was, the lower PVD and MVD were. Compared to traditional glaucoma staging system judged by VF, the changes of PVD and MVD obtained by OCTA might be a new method to grade the stage of glaucoma. These findings theorize that the changes of PVD and MVD may be better facilitated for the observation and monitoring of glaucoma progression.
比较原发性闭角型青光眼（PACG）的视网膜血管密度和青光眼参数，评估视网膜血管密度在青光眼进展中的诊断和监测能力。
本研究为观察性、前瞻性和横断面研究。根据青光眼分期系统，将 218 只眼（116 名参与者）分为 5 组：无青光眼、早期青光眼、中度青光眼、进展期青光眼、严重青光眼。所有参与者均接受全面的眼部检查，包括矫正远视力测量、裂隙灯显微镜检查、眼压（IOP）、房角镜检查、眼底检查、立体视盘照相、Humphrey 视野检查（VF）、视网膜神经纤维层（RNFL）、节细胞内丛状层（GCIPL）、视盘旁和黄斑 OCTA 扫描。采用 SPSS 软件计算并比较视网膜血管密度（视盘旁血管密度，PVD 和黄斑血管密度，MVD）和青光眼参数（平均偏差（MD）、模式标准差（PSD）、RNFL 厚度、GCIPL 厚度、视盘边缘面积、平均杯/盘（C/D）比）。
PACG 患者的 GCIPL 厚度、RNFL 厚度、PVD 和 MVD 显著降低。各组间各项测量值差异均有统计学意义（P<0.01）。青光眼患者的视盘旁和黄斑血管密度降低，与青光眼分期有统计学相关性（P<0.01）。此外，视网膜血管密度、RNFL 厚度和 GCIPL 厚度的降低与青光眼的分期也有统计学关系。正如预期的那样，随着疾病严重程度的增加，青光眼眼的边缘面积显著减小，C/D 比值增大。
PVD 和 MVD 的变化与 GCIPL 厚度和 RNFL 厚度呈强正相关，与青光眼的严重程度呈负相关，即青光眼越严重，PVD 和 MVD 越低。与传统的基于 VF 判断的青光眼分期系统相比，OCTA 获得的 PVD 和 MVD 的变化可能是一种新的青光眼分期方法。这些发现推测，PVD 和 MVD 的变化可能更有利于观察和监测青光眼的进展。
