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原发性开角型青光眼微视野检查中视网膜敏感度与光学相干断层扫描血管造影中血管密度的相关性

Correlation of retinal sensitivity in microperimetry with vascular density in optical coherence tomography angiography in primary open-angle glaucoma.

作者信息

Zabel Katarzyna, Zabel Przemyslaw, Kaluzna Martyna, Lamkowski Aleksander, Jaworski Damian, Wietlicka-Piszcz Magdalena, Kaluzny Jakub J

机构信息

Department of Sensory Organ Studies, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.

Oftalmika Eye Hospital, Bydgoszcz, Poland.

出版信息

PLoS One. 2020 Jul 6;15(7):e0235571. doi: 10.1371/journal.pone.0235571. eCollection 2020.

Abstract

PURPOSE

To evaluate the correlation between retinal sensitivity in microperimetry (MP) with vessel density (VD) using optical coherence tomography angiography (OCTA) in primary open-angle glaucoma (POAG).

METHODS

We enrolled 30 participants (52 eyes) with POAG and 15 participants (23 eyes) in the healthy control group. All participants were examined for retinal structure using OCTA to assess VD and Spectral domain OCT (SD-OCT) to assess ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness. Retinal sensitivity was tested with MP and standard automatic perimetry (SAP).

RESULTS

The VD in moderate/severe POAG was lower than that in mild POAG and healthy control in the macular superficial vascular plexus (SVP) (38.7±6.3% vs. 42.9±5.2%, 49.7±2.6% respectively, P<0.001) and peripapillary radial peripapillary capillaries (pRPC) (36.4±5.7% vs. 43.6±6.6%, 49.1±2.4% respectively, P<0.001). The Pearson's correlations between function-structure parameters were strongest with MP average sensitivity threshold and SVP VD in the area of whole macula (r = 0.68); followed by SAP mean deviation (MD) and pRNFL thickness (r = 0.63); SAP MD and pRPC VD (r = 0.59) and MP average threshold and GCC thickness (r = 0.54). We found the AUROCs for discriminating between glaucomatous and healthy eyes were highest for structural parameters as follows: pRNFL (0.94), macular SVP whole (0.92), pRPC (0.92) and GCC (0.91). Pairwise comparison of the above parameters showed no difference (P>0.05).

CONCLUSION

The relationship between microvascular damage in the macular SVP whole and the decrease of MP average sensitivity threshold is stronger than the pRNFL thickness measurements and SAP parameters. OCTA and MP techniques are valuable methods that allow clinically monitor structural and functional changes in glaucomatous eyes.

摘要

目的

利用光学相干断层扫描血管造影(OCTA)评估原发性开角型青光眼(POAG)患者微视野检查(MP)中的视网膜敏感度与血管密度(VD)之间的相关性。

方法

我们纳入了30例POAG患者(52只眼)和15例健康对照组参与者(23只眼)。所有参与者均接受OCTA检查以评估视网膜结构从而测定VD,同时接受光谱域光学相干断层扫描(SD-OCT)以评估神经节细胞复合体(GCC)和视乳头周围视网膜神经纤维层(pRNFL)厚度。采用MP和标准自动视野计(SAP)检测视网膜敏感度。

结果

中度/重度POAG患者黄斑浅表血管丛(SVP)的VD低于轻度POAG患者和健康对照组(分别为38.7±6.3% 、42.9±5.2%、49.7±2.6%,P<0.001),视乳头周围放射状视乳头周围毛细血管(pRPC)的VD也低于轻度POAG患者和健康对照组(分别为36.4±5.7% 、43.6±6.6%、49.1±2.4%,P<0.001)。功能-结构参数之间的Pearson相关性在全黄斑区域以MP平均敏感度阈值与SVP的VD最强(r = 0.68);其次是SAP平均偏差(MD)与pRNFL厚度(r = 0.63);SAP MD与pRPC的VD(r = 0.59)以及MP平均阈值与GCC厚度(r = 0.54)。我们发现用于鉴别青光眼性眼与健康眼的受试者工作特征曲线下面积(AUROC)在结构参数方面最高的如下:pRNFL(0.94)、黄斑SVP全层(0.92)、pRPC(0.92)和GCC(0.91)。上述参数的两两比较无差异(P>0.05)。

结论

黄斑SVP全层微血管损伤与MP平均敏感度阈值降低之间的关系比pRNFL厚度测量值和SAP参数更强。OCTA和MP技术是临床上监测青光眼性眼结构和功能变化的有价值方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6fc/7337279/06bdfd8516b0/pone.0235571.g001.jpg

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