Princess Alexandra Eye Pavilion, NHS Lothian, 45 Chalmers Street, Edinburgh, EH3 9HA, UK.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Sci Rep. 2021 Jan 13;11(1):1056. doi: 10.1038/s41598-020-80080-z.
The aim of this study was to investigate the relationship between glaucoma severity and perifoveal vessel density (pfVD), branching complexity, and foveal avascular zone (FAZ) size in normal tension glaucoma (NTG). 31 patients with NTG washed out of glaucoma medications were subjected to tests including; intraocular pressure measurement; standard automated perimetry; optical coherence tomography (OCT) measurement of macular ganglion cell complex (mGCC), inner macular thickness (IMT) and circumpapillary retinal nerve fibre layer (cpRNFL); and OCT angiography measurement of pfVD, FAZ perimeter and multispectral fractal dimensions (MSFD). Eyes with more severe glaucoma had significantly thinner mGCC and cpRNFL and lower pfVD. MD decreased by 0.4 dB (95% CI 0.1 to 0.6 dB, P = 0.007) for every 1% decrease in pfVD. Lower MSFD was observed in eyes with lower pfVD and in patients with systemic hypertension. Multivariable analysis, accounting for age and OCTA quality, found lower pfVD remained significantly associated with thinner IMT, thinner mGCC and worse MD but not with MSFD. pfVD was reduced in NTG and was diminished in eyes with worse MD. Macular vessel branching complexity was not related to severity of visual field loss but was lower in patients with systemic hypertension.
本研究旨在探讨正常眼压性青光眼（NTG）中青光眼严重程度与中心凹旁血管密度（pfVD）、分支复杂性和中心凹无血管区（FAZ）大小之间的关系。31 例停用降眼压药物的 NTG 患者接受了以下检查：眼压测量、标准自动视野计检查、光学相干断层扫描（OCT）测量黄斑神经节细胞复合体（mGCC）、内黄斑厚度（IMT）和环周视网膜神经纤维层（cpRNFL）以及 OCT 血管造影测量 pfVD、FAZ 周长和多光谱分形维数（MSFD）。青光眼严重程度较高的眼 mGCC 和 cpRNFL 明显变薄，pfVD 较低。pfVD 每降低 1%，平均缺损（MD）下降 0.4dB（95%置信区间 0.1 至 0.6dB，P=0.007）。pfVD 较低的眼和合并高血压的患者观察到较低的 MSFD。多变量分析，考虑年龄和 OCTA 质量，发现较低的 pfVD 仍然与较薄的 IMT、较薄的 mGCC 和更差的 MD 显著相关，但与 MSFD 无关。NTG 患者的 pfVD 减少，MD 较差的患者 pfVD 减少。黄斑血管分支复杂性与视野丧失严重程度无关，但在合并高血压的患者中较低。
