Department of Ophthalmology, Asan Medical Center, Seoul, Korea (the Republic of).
Department of Ophthalmology, Asan Medical Center, Seoul, Korea (the Republic of)
Br J Ophthalmol. 2021 Jul;105(7):964-969. doi: 10.1136/bjophthalmol-2020-315973. Epub 2020 Aug 11.
BACKGROUND/AIMS: To determine the tipping point at which peripapillary vessel density (pVD), measured using optical coherence tomography angiography (OCT-A), is associated with detectable visual field (VF) loss in cases of open-angle glaucoma (OAG).
Peripapillary retinal nerve fibre layer (pRNFL) thickness and pVD were measured using OCT and OCT-A in 166 healthy participants, those with suspected glaucoma and patients with early-stage OAG. All participants were Koreans. A broken-stick model was used to determine the tipping points below which pRNFL thickness (pRNFLT) or pVD reduction was associated with significant VF loss. The slopes were computed above and below the tipping points for the relationship between pVD, pRNFLT and VF sensitivity (VFS).
Tipping points were detected for pRNFLT globally and in the inferior and superior quadrants, at which there were significant differences between the slopes above and below the tipping points. The slopes above the tipping points were approximately zero. However, no tipping point was found for pVD in the global area or regional sectors.
The relationship between pVD and VFS does not show a tipping point. This suggests that the correlation between pVD-VFS may be linear and stronger than that of pRNFLT-VFS, even at the early stage of glaucoma.
背景/目的：确定使用光学相干断层扫描血管造影（OCT-A）测量的周边视网膜血管密度（pVD）与开角型青光眼（OAG）病例中可检测到的视野（VF）损失相关的临界点。
使用 OCT 和 OCT-A 测量了 166 名健康参与者、疑似青光眼患者和早期 OAG 患者的周边视网膜神经纤维层（pRNFL）厚度和 pVD。所有参与者均为韩国人。使用折断棒模型确定 pRNFL 厚度（pRNFLT）或 pVD 降低与显著 VF 损失相关的临界点以下的临界点。计算了临界点上方和下方 pVD、pRNFLT 和 VF 敏感性（VFS）之间关系的斜率。
在全球范围以及在下侧和上侧象限中检测到了 pRNFLT 的临界点，在这些临界点上方和下方的斜率之间存在显著差异。临界点上方的斜率接近零。然而，在全球区域或区域扇区中未发现 pVD 的临界点。
pVD 与 VFS 之间的关系没有显示出临界点。这表明 pVD-VFS 之间的相关性可能是线性的，并且比 pRNFLT-VFS 更强，即使在青光眼的早期阶段也是如此。
