Glaucoma Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2021 May;69(5):1120-1126. doi: 10.4103/ijo.IJO_1191_20.
Evaluation of circumpapillary vessel density (VD) and perfusion density (PD) on optical coherence tomography angiography (OCTa) in mild-moderate glaucoma patients having unilateral visual field defects, with their fellow eyes and controls.
Both eyes of 24 patients having a definitive nasal step or arcuate scotoma in one hemisphere of one eye only, and 24 controls, underwent OCTa.
In eyes with a superior field defect, the superior/inferior quadrant ratios, (SQ/IQ) of 3 mm scan of VD and PD were significantly higher in eyes with a superior arcuate scotoma than fellow eyes (P = 0.03,0.02) as also controls, (P = 0.004,0.001). The mean percentage loss of inferior quadrant VD between control to fellow eyes, and superior nasal step eyes were similar, 20.19%/19.57% respectively, P = 0.85, while a loss in arcuate scotoma eyes was 38.81% (P = 0.001). The percentage decrease in inferior quadrant PD in fellow eyes was 14.70%, superior nasal step 23.39%, and an arcuate scotoma 34.74% (P = 0.02). Eyes with a superior nasal step had significantly lower VD and PD absolute values in the inferior quadrant OCTa in 3 mm and 6 mm circle scan only as compared to control eyes, VD, P = 0.03,0.04/PD, P = 0.008,0.02. Fellow eyes of superior field defects had significantly lower VD and PD absolute values in the inferior quadrant in 3 mm and 6 mm circle scan as compared to control eyes, VD, P = 0.006,0.04/PD, P = 0.01,0.03. Eyes with an isolated inferior field defect in only one eye, showed a significant decrease in both VD and PD in all quadrants as compared to fellow eyes and control eyes. A significant positive correlation was found between VD and RNFL thickness in peripapillary superior unaffected quadrants in eyes with superior field defects and inferior unaffected quadrants in inferior defects (P = 0.001 and 0.01).
There was a statistically significant increasing SQ/IQ ratio and percentage loss of vascular parameters from control to fellow eyes, those with a superior nasal step, and those with a superior arcuate scotoma. Inferior VFDs appeared to be associated with a more generalized circulatory loss. The asymmetry between hemispheres and between eyes could be used as a biomarker for early glaucomatous neuropathy.
评估单侧视野缺损患者对侧眼和正常对照者的光学相干断层扫描血管造影（OCTa）的周边血管密度（VD）和灌注密度（PD）。
对 24 例单侧视野缺损患者中只有一只眼存在明确的鼻侧阶梯或弓形暗点的双眼和 24 例对照者进行 OCTa 检查。
在上方视野缺损的眼中，上方/下方象限比（SQ/IQ）在上方弓形暗点眼的 3mm 扫描中明显高于对侧眼（P=0.03,0.02），也高于对照组（P=0.004,0.001）。从对照组到对侧眼和上方鼻侧阶梯眼，下方象限 VD 的平均百分比损失相似，分别为 20.19%/19.57%，P=0.85，而在弓形暗点眼中的损失为 38.81%（P=0.001）。下方象限 PD 在对侧眼的下降百分比为 14.70%，上方鼻侧阶梯眼为 23.39%，弓形暗点眼为 34.74%（P=0.02）。只有上方鼻侧阶梯眼在 3mm 和 6mm 圆扫描中的下方象限 OCTa 中 VD 和 PD 的绝对值明显低于对照组，VD，P=0.03,0.04/PD，P=0.008,0.02。上方视野缺损的对侧眼在 3mm 和 6mm 圆扫描中的下方象限的 VD 和 PD 的绝对值明显低于对照组，VD，P=0.006,0.04/PD，P=0.01,0.03。只有一只眼存在孤立的下方视野缺损的眼，与对侧眼和对照组相比，所有象限的 VD 和 PD 均明显下降。在上方视野缺损的眼的上方未受影响的象限和下方视野缺损的眼的下方未受影响的象限中，发现 VD 和神经纤维层厚度之间存在显著的正相关（P=0.001 和 0.01）。
从对照组到对侧眼、上方鼻侧阶梯眼和上方弓形暗点眼，血管参数的 SQ/IQ 比值和百分比损失均有统计学意义。下方 VFD 似乎与更广泛的循环损失有关。半球之间和眼之间的不对称性可以作为早期青光眼神经病变的生物标志物。
