Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Ophthalmol. 2022 Feb;100(1):e174-e180. doi: 10.1111/aos.14856. Epub 2021 Mar 19.
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).
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.
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.
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.
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。
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。
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。
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。