The Viterbi Family Department of Ophthalmology and Shiley Eye Institute, Hamilton Glaucoma Center.
UCSD School of Medicine, University of California San Diego, La Jolla, CA.
J Glaucoma. 2020 Nov;29(11):1025-1029. doi: 10.1097/IJG.0000000000001647.
PRéCIS:: Small but significant decreases in optical coherence tomography angiography (OCTA)-measured circumpapillary capillary density (cpCD) were observed in healthy eyes dilated with 2.5% phenylephrine/0.5% tropicamide. Although likely clinically insignificant, ophthalmologists should consider these changes when interpreting OCTA results from dilated eyes.
The purpose of this study was to investigate the effect of pupil dilation using 2.5% phenylephrine and 0.5% tropicamide on quantitative assessment of retinal microvasculature using OCTA.
OptoVue AngioVue high density (HD) and non-HD OCTA macula and optic nerve head (ONH) images were obtained at 15-minute intervals predilation and postdilation in 26 healthy participants (mean age: 40.0; 95% confidence interval=33.9, 46.1 y). Superficial macular vessel density (VD) was measured in the whole image VD and the parafoveal region VD. ONH capillary density was measured in the whole image capillary density and the cpCD region. Differences between predilation and postdilation densities were assessed using linear mixed effects models to account for within-patient correlation.
Instillation of dilating drops resulted in a small but statistically significant reduction in non-HD ONH whole image capillary density of 0.6%, from a mean of 45.2% (95% confidence interval=41.9%, 48.4%) to 44.6% (41.4%, 47.8%) (P=0.046). A similar reduction in non-HD ONH cpCD of 0.8% also was observed, from a mean of 49.3% (45.3%, 53.3%) to 48.5% (44.5%, 52.4%) (P=0.025). No postdilation decreases in macular VD or HD ONH capillary density were observed.
Pupil dilation using topical 2.5% phenylephrine and 0.5% tropicamide results in a small but statistically significant reduction in non-HD ONH whole image and cpCD in healthy eyes. The observed reduction likely is not clinically significant because the observed reduction was within the previously reported range of measurement variability. Further studies should consider investigating these effects in nonhealthy eyes with glaucoma and media opacities, as well as older individuals.
在使用 2.5%苯肾上腺素和 0.5%托吡卡胺散瞳后，健康眼的光相干断层扫描血管造影 (OCTA) 测量的环周毛细血管密度 (cpCD) 出现了微小但有统计学意义的下降。尽管可能在临床上无足轻重，但眼科医生在解释散瞳后 OCTA 结果时应考虑到这些变化。
本研究旨在探讨使用 2.5%苯肾上腺素和 0.5%托吡卡胺散瞳对 OCTA 评估视网膜微血管定量的影响。
在 26 名健康参与者（平均年龄：40.0 岁；95%置信区间=33.9，46.1 岁）中，分别在散瞳前 15 分钟和散瞳后每隔 15 分钟进行 OptoVue AngioVue 高密度 (HD) 和非 HD OCTA 黄斑和视神经头 (ONH) 图像采集。在全图像 VD 和旁黄斑区 VD 中测量浅层黄斑血管密度 (VD)。在全图像毛细血管密度和 cpCD 区域测量 ONH 毛细血管密度。使用线性混合效应模型评估预扩瞳和扩瞳后密度之间的差异，以考虑患者内相关性。
散瞳滴剂的滴入导致非 HD ONH 全图像毛细血管密度出现微小但具有统计学意义的降低，从平均 45.2%（95%置信区间=41.9%，48.4%）降至 44.6%（41.4%，47.8%）（P=0.046）。非 HD ONH cpCD 也观察到类似的 0.8%的降低，从平均 49.3%（45.3%，53.3%）降至 48.5%（44.5%，52.4%）（P=0.025）。未观察到黄斑 VD 或 HD ONH 毛细血管密度在散瞳后的降低。
使用局部 2.5%苯肾上腺素和 0.5%托吡卡胺散瞳可导致健康眼的非 HD ONH 全图像和 cpCD 出现微小但具有统计学意义的降低。观察到的减少量可能在临床上并不显著，因为观察到的减少量在先前报道的测量变异性范围内。进一步的研究应该考虑在患有青光眼和介质混浊的非健康眼以及老年人中研究这些影响。
