根据疾病阶段，广角型青光眼患者视网膜毛细血管密度进行性损失与视野进展之间的关系。
Association Between Progressive Retinal Capillary Density Loss and Visual Field Progression in Open-Angle Glaucoma Patients According to Disease Stage.
机构信息
From the Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
From the Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
出版信息
Am J Ophthalmol. 2021 Jun;226:137-147. doi: 10.1016/j.ajo.2021.01.015. Epub 2021 Jan 30.
PURPOSE
To investigate the longitudinal changes in circumpapillary capillary density (cpCD) and retinal nerve fiber layer thickness (cpRNFLT) and their association with visual field (VF) progression in open-angle glaucoma (OAG) eyes at different stages of glaucoma.
DESIGN
Retrospective, observational case series METHODS: This study enrolled 158 eyes of 158 OAG patients classified into early (89 eyes) and moderate-to-advanced (69 eyes) stage based on VF mean deviation (MD; -6 dB). Serial cpCD and cpRNFLT measurements were performed using optical coherence tomography (OCT) angiography and OCT during a mean follow-up of 2.66 years. The reference standard of glaucoma progression was determined by VF progression. The rates of longitudinal change in cpCD and cpRNFLT were evaluated using linear mixed effects models and compared between progressors and nonprogressors. The factors associated with VF progression, including the rates of longitudinal change in cpCD and cpRNFLT, were assessed using logistic regression analyses.
RESULTS
The rate of longitudinal change in cpCD was significantly faster in progressors (-1.25% ± 1.15% per year for early stage and -1.61% ± 1.04% per year for moderate-to-advanced stage) than in nonprogressors (0.04% ± 1.12% per year for early stage and -0.34% ± 0.97% per year for moderate-to-advanced stage) regardless of glaucoma stage (all, P < .05). The rates of longitudinal change in cpRNFLT (-0.85 ± 1.20 µm/y vs -0.70 ± 1.02 µm/y, P = .396) did not differ between progressors and nonprogressors in eyes with moderate-to-advanced glaucoma. In multivariable logistic regression analyses, a faster rate of cpCD loss (odds ratio [OR] 0.244, P = .009) had a significant association with VF progression in eyes with moderate-to-advanced glaucoma, whereas faster rates of both cpCD (OR 0.340, P = .012) and cpRNFLT (OR 0.155, P = .031) loss were significantly associated with VF progression in eyes with early-stage glaucoma.
CONCLUSIONS
In OAG eyes, the rate of longitudinal cpCD loss was significantly associated with VF progression regardless of glaucoma stage.
目的
研究开角型青光眼（OAG）不同阶段患者的眼周毛细血管密度（cpCD）和视网膜神经纤维层厚度（cpRNFLT）的纵向变化及其与视野（VF）进展的关系。
设计
回顾性观察性病例系列研究
方法
本研究纳入了 158 例 158 只 OAG 患者的眼，根据 VF 平均偏差（MD；-6 dB）将其分为早期（89 只眼）和中晚期（69 只眼）。使用光学相干断层扫描（OCT）血管造影和 OCT 对眼周 cpCD 和 cpRNFLT 进行了平均 2.66 年的连续测量。青光眼进展的参考标准是通过 VF 进展确定的。使用线性混合效应模型评估 cpCD 和 cpRNFLT 的纵向变化率，并比较进展者和非进展者之间的差异。使用逻辑回归分析评估与 VF 进展相关的因素，包括 cpCD 和 cpRNFLT 的纵向变化率。
结果
进展者的眼周 cpCD 纵向变化率明显快于非进展者（早期阶段为-1.25%±1.15%/年，中晚期为-1.61%±1.04%/年）（早期阶段为 0.04%±1.12%/年，中晚期为-0.34%±0.97%/年），无论青光眼阶段如何（均 P<0.05）。中晚期青光眼患者中，cpRNFLT 的纵向变化率（-0.85±1.20 µm/y 与-0.70±1.02 µm/y，P=0.396）在进展者和非进展者之间没有差异。多变量逻辑回归分析显示，中晚期青光眼患者中 cpCD 丢失速度较快（优势比 [OR] 0.244，P=0.009）与 VF 进展显著相关，而早期青光眼患者中 cpCD（OR 0.340，P=0.012）和 cpRNFLT（OR 0.155，P=0.031）丢失速度较快均与 VF 进展显著相关。
结论
在 OAG 患者中，无论青光眼阶段如何，cpCD 的纵向丢失率与 VF 进展均显著相关。
Zotero 插件