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青光眼患者视盘神经纤维层缺损部位附近仅出现神经节细胞层深层毛细血管缺失。

Parapapillary deep-layer microvasculature dropout is only found near the retinal nerve fibre layer defect location in open-angle glaucoma.

机构信息

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Acta Ophthalmol. 2022 Feb;100(1):e174-e180. doi: 10.1111/aos.14856. Epub 2021 Mar 19.

Abstract

PURPOSE

We aimed to investigate the topographic correspondence between deep-layer microvasculature dropout (MvD) and retinal nerve fibre layer (RNFL) defects in eyes with open-angle glaucoma (OAG) using spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCT-A).

METHODS

Microvasculature dropout width and location were determined using OCT-A, RNFL thickness, RNFL defect width and location were revealed using SD-OCT. The association between MvD and RNFL widths and that between the location of the MvD and RNFL defects were investigated. In addition, patients with OAG were divided into two groups: the RNFL defect in one hemiretina (RNFLD-HR) group (n = 24 eyes) and the RNFL defects in both hemiretinas (RNFLD-BR) group (n = 25 eyes). The presence, width and location of MvDs were compared between the two groups.

RESULTS

Forty-nine eyes were included. In 24 RNFLD-HR eyes, all MvDs were found in the inferior area, corresponding with the location of the RNFL defect. Meanwhile, in 25 RNFLD-BR eyes, 18 MvDs (72%) were found in the inferior hemiretina, two (8%) were found in the superior hemiretina, and five (20%) were found in both hemiretinas. In RNFLD-BR eyes, the average RNFL thickness was thinner in a location with MvD than a location without MvD.

CONCLUSION

Considering that MvD is only observed at the location of the RNFL defect in RNFLD-HR eyes and is usually found in the location of more severe RNFL defects in RNFLD-BR eyes, MvD seems to be a sign that accompanies glaucomatous damage in OAG eyes.

摘要

目的

本研究旨在利用频域光相干断层扫描(SD-OCT)和光相干断层扫描血管造影(OCT-A)技术,研究开角型青光眼(OAG)患者深层微血管丢失(MvD)与视网膜神经纤维层(RNFL)缺损的 topography 对应关系。

方法

采用 OCT-A 确定 MvD 的宽度和位置,采用 SD-OCT 揭示 RNFL 厚度、RNFL 缺损宽度和位置。研究了 MvD 与 RNFL 宽度之间的相关性,以及 MvD 位置与 RNFL 缺损之间的相关性。此外,将 OAG 患者分为两组:一只半视网膜 RNFL 缺损(RNFLD-HR)组(n=24 只眼)和两只半视网膜 RNFL 缺损(RNFLD-BR)组(n=25 只眼)。比较两组患者 MvD 的存在、宽度和位置。

结果

共纳入 49 只眼。在 24 只 RNFLD-HR 眼中,所有 MvD 均位于下方区域,与 RNFL 缺损的位置相对应。而在 25 只 RNFLD-BR 眼中,18 只 MvD(72%)位于下方半视网膜,2 只(8%)位于上方半视网膜,5 只(20%)位于两只半视网膜。在 RNFLD-BR 眼中,有 MvD 的位置 RNFL 厚度比无 MvD 的位置更薄。

结论

考虑到 RNFLD-HR 眼中的 MvD 仅出现在 RNFL 缺损的位置,而在 RNFLD-BR 眼中 MvD 通常出现在更严重的 RNFL 缺损的位置,因此 MvD 似乎是 OAG 眼中伴随青光眼损伤的一个标志。

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