Department of Glaucoma, Narayana Nethralaya, Hulimavu.
Department of Glaucoma, University Eye Clinic Maastricht, University Medical Center, Maastricht, The Netherlands.
J Glaucoma. 2021 Mar 1;30(3):e61-e67. doi: 10.1097/IJG.0000000000001745.
Lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) on optical coherence tomography angiography (OCTA) were significantly associated with faster rate of mean deviation (MD) decline.
To evaluate the association between OCTA features and prior visual field (VF) progression in primary angle closure glaucoma (PACG).
In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over ≥3 years of follow-up underwent OCTA imaging. Effect of clinical (age, sex, number of antiglaucoma medications, mean, and SD of intraocular pressure during follow-up), optical coherence tomography (average retinal nerve fiber layer and ganglion cell complex thickness) and OCTA (whole enface vessel density of disc and macular scan, deep-layer microvascular dropout) parameters on the rate of MD change was evaluated using linear mixed models.
Average (±SD) MD of the baseline VF was -7.4±7.3 dB, and rate of MD change was -0.32±0.29 dB/y. Whole enface vessel density of disc and macular scans was 39.5%±8.1% and 38.7%±4.4%, respectively. Microvascular dropout was noted in 33.3% of the eyes. Multivariate mixed models showed that lower whole enface disc (coefficient: 0.02, P=0.03) and macular vessel densities (coefficient: 0.04, P=0.02) were significantly associated with faster rate of MD decline. Other factors significantly associated with faster progression in multivariate models were older age (coefficient: -0.02, P<0.05) and the presence of systemic hypertension (coefficient: -0.37, P=0.01) and diabetes (coefficient: -0.28, P=0.05).
Lower superficial vessel density measured using OCTA was significantly associated with faster VF progression in PACG. In these eyes, OCTA parameters can serve as biomarker suggestive of past VF progression.
光学相干断层扫描血管造影（OCTA）上的全视盘下整体盘（系数：0.02，P=0.03）和黄斑血管密度（系数：0.04，P=0.02）与平均偏差（MD）下降速度明显相关。
评估原发性闭角型青光眼（PACG）中 OCTA 特征与先前视野（VF）进展之间的关系。
在一项横断面研究中，对 31 名 PACG 患者的 46 只眼进行了研究，这些患者在≥3 年的随访中进行了 5 次可靠的 VF 检查，进行了 OCTA 成像。使用线性混合模型评估临床（年龄、性别、抗青光眼药物数量、随访期间平均和标准差眼压）、光学相干断层扫描（平均视网膜神经纤维层和节细胞复合体厚度）和 OCTA（视盘和黄斑扫描的全视盘血管密度、深层微血管丢失）参数对 MD 变化率的影响。
基线 VF 的平均（±SD）MD 为-7.4±7.3 dB，MD 变化率为-0.32±0.29 dB/y。视盘和黄斑扫描的全视盘血管密度分别为 39.5%±8.1%和 38.7%±4.4%。33.3%的眼睛出现微血管丢失。多变量混合模型显示，视盘和黄斑扫描的全视盘血管密度较低（系数：0.02，P=0.03）与 MD 下降速度较快有关。多变量模型中与较快进展相关的其他因素还有年龄较大（系数：-0.02，P<0.05）、高血压（系数：-0.37，P=0.01）和糖尿病（系数：-0.28，P=0.05）。
OCTA 测量的浅层血管密度较低与 PACG 中的 VF 进展较快显著相关。在这些眼睛中，OCTA 参数可以作为过去 VF 进展的生物标志物。
