Calzetti Giacomo, Mursch-Edlmayr Anna Sophie, Bata Ahmed M, Ungaro Nicola, Mora Paolo, Chua Jacqueline, Schmidl Doreen, Bolz Matthias, Garhöfer Gerhard, Gandolfi Stefano, Schmetterer Leopold, Wong Damon
Department of Ophthalmology, University Hospital of Parma, Parma, Italy.
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
Acta Ophthalmol. 2022 Feb;100(1):e181-e191. doi: 10.1111/aos.14862. Epub 2021 Apr 20.
We aimed to describe the global and localized correlations among visual field (VF) sensitivity, optic nerve head (ONH) perfusion measured by laser speckle flowgraphy (LSFG) and neural structure measured by optical coherence tomography (OCT) in open-angle glaucoma (OAG) and to compare the floor effect for LSFG and OCT.
Cross-sectional, multicenter study including one eye each from fifty OAG patients (mean age 69.3 years; average VF mean deviation, MD, -8.5 dB, range -25.17 to 0.85 dB) and fifty-one controls. Patients underwent SITA standard 24-2 automated perimetry and measurement of ONH perfusion, peripapillary retinal nerve fibre layer thickness (RNFLT) and macular ganglion cell-inner plexiform layer thickness (GCIPLT). We tested the presence of a significant change (breakpoint) in the correlation slope with VF sensitivity to assess floor effect.
The correlation between the LSFG parameter Mean All (MA) of the global disc area and MD (r = 0.56, p < 0.001) did not show a breakpoint, in contrast to the correlations between MD and OCT global parameters, which showed breakpoints at -8.53 and -4.05 dB for RNFLT and GCIPLT, respectively. Global and localized correlations with VF sensitivity were stronger for LSFG compared to OCT. In particular, LSFG outperformed OCT in the correlation with the central VF sector (r = 0.50, p < 0.001 and r = 0.06, p = 0.67 for MA and RNFLT, respectively).
The global and sectoral correlations with VF sensitivity and the favourable floor effect compared to OCT indicate LSFG as a promising tool to monitor progression particularly in late-stage glaucoma. Further longitudinal studies are warranted.
我们旨在描述开角型青光眼（OAG）患者视野（VF）敏感度、通过激光散斑血流图（LSFG）测量的视神经乳头（ONH）灌注以及通过光学相干断层扫描（OCT）测量的神经结构之间的整体和局部相关性，并比较LSFG和OCT的下限效应。
一项横断面、多中心研究，纳入50例OAG患者（平均年龄69.3岁；平均VF平均偏差，MD，-8.5dB，范围-25.17至0.85dB）和51例对照者的单眼。患者接受了SITA标准24-2自动视野检查以及ONH灌注、视乳头周围视网膜神经纤维层厚度（RNFLT）和黄斑神经节细胞-内丛状层厚度（GCIPLT）的测量。我们测试了与VF敏感度的相关性斜率中是否存在显著变化（断点）以评估下限效应。
与MD和OCT整体参数之间的相关性不同，全球盘区的LSFG参数平均总和（MA）与MD之间的相关性（r = 0.56，p < 0.001）未显示断点，MD与RNFLT和GCIPLT的相关性分别在-8.53和-4.05dB处显示断点。与OCT相比，LSFG与VF敏感度的整体和局部相关性更强。特别是，在与中央VF扇区的相关性方面，LSFG优于OCT（MA和RNFLT的r分别为0.50，p < 0.001和r = 0.06，p = 0.67）。
与VF敏感度的整体和扇形相关性以及与OCT相比有利的下限效应表明，LSFG是监测青光眼进展尤其是晚期青光眼进展的有前景的工具。有必要进行进一步的纵向研究。
