Singapore Eye Research Institute, Singapore National Eye Centre.
University of Southern California, Los Angeles, CA.
J Glaucoma. 2021 Jun 1;30(6):465-472. doi: 10.1097/IJG.0000000000001828.
Reduction of intraocular pressure (IOP) by latanoprost in treatment-naive eyes is significantly correlated to an increase in vessel density (VD) at the optic nerve head (ONH).
To evaluate the effect of topical latanoprost on ocular microvasculature using optical coherence tomography angiography (OCTA).
In this prospective case-control study, 26 eyes from 18 treatment-naive subjects in whom prostaglandin analogue (PGA) latanoprost 0.005% was initiated were included as cases. In 10 out of the 18 subjects, medication was initiated in only 1 eye; their contralateral untreated eyes were used as controls. OCTA (AngioVue, Optovue Inc., Fremont, CA) was performed at baseline and ≥3 weeks after commencing treatment. Main outcome measures were change in flow area and VD at the ONH, radial peripapillary capillaries (RPC), and macula. Comparison between the 2 visits was performed using a linear mixed model adjusted for intereye correlation and mean ocular perfusion pressure.
IOP decreased by 26.1%±11.3% (P<0.001) in the cases and 0.18%±12.2% (P=0.63) in controls. Significant correlations between change in IOP and change in ONH VD (correlation coefficient [r]=-0.42, P=0.04), and between change in IOP and change in RPC VD (r=-0.48, P=0.02) were observed in the cases, whereas none were observed in the controls. When multiple testing was considered, no significant changes in flow area and VD were observed in cases and controls.
The reduction of IOP by a PGA in treatment-naive eyes was significantly correlated to the increase in ONH VD and RPC VD. This may indicate a mechanism by which IOP reduction modulates the risk of glaucoma progression by improving ocular microperfusion.
在未经治疗的眼中，前列腺素类似物（PGA）拉坦前列素 0.005% 降低眼压（IOP）与视神经头（ONH）血管密度（VD）增加显著相关。
使用光相干断层扫描血管造影（OCTA）评估局部应用拉坦前列素对眼微循环的影响。
在这项前瞻性病例对照研究中，纳入了 18 名未经治疗的受试者中的 26 只眼，他们开始使用前列腺素类似物（PGA）拉坦前列素 0.005%。在这 18 名受试者中，有 10 名仅在一只眼中开始用药；他们未用药的对侧眼作为对照。在基线和开始治疗后≥3 周时进行 OCTA（AngioVue，Optovue Inc.，弗里蒙特，加利福尼亚州）。主要观察指标是 ONH、放射状视神经周围毛细血管（RPC）和黄斑区的血流面积和 VD 的变化。使用线性混合模型，根据眼间相关性和平均眼灌注压对两次就诊进行比较。
病例组的 IOP 下降了 26.1%±11.3%（P<0.001），对照组下降了 0.18%±12.2%（P=0.63）。在病例组中，观察到 IOP 变化与 ONH VD 变化之间存在显著相关性（相关系数[r]=-0.42，P=0.04），以及 IOP 变化与 RPC VD 变化之间存在显著相关性（r=-0.48，P=0.02），而在对照组中未观察到这些相关性。考虑到多次测试，病例组和对照组的血流面积和 VD 均无显著变化。
在未经治疗的眼中，PGA 降低 IOP 与 ONH VD 和 RPC VD 的增加显著相关。这可能表明，通过改善眼微循环，降低 IOP 可以调节青光眼进展的风险。
