Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, 06591, Seoul, Republic of Korea.
Sci Rep. 2021 May 11;11(1):9941. doi: 10.1038/s41598-021-89428-5.
We investigated the characteristics of localized vessel density defects (VD) either in the deep or superficial vascular layer of normal-tension glaucoma patients using optical coherence tomography angiography (OCTA). In this retrospective, cross-sectional study, 74 eyes with localized retinal nerve fiber layer (RNFL) defect were included. The relationships between the widths of the VD in the superficial and deep layer and ocular factors were evaluated. Eyes with greater deep VD were significantly older (P = 0.023). The IOP measured at OCTA exam was significantly related to the width of the deep VD (P = 0.009). By contrast, average ganglion cell inner plexiform layer thickness (GCIPLT) was substantially related to the width of the superficial VD (P = 0.004). In logistic regression analysis, aging was noticeably associated with wider deep VD, whereas worse mean deviation (MD) had a significant association with wider superficial VD (P = 0.001, P = 0.003, respectively). In sum, while changes of the superficial layer seemed an overall ramification of glaucomatous damages, the deep layer was more likely to be affected by factors related to ocular microcirculation, such as IOPs and older age. Thus, looking into the deep vascular layer using OCTA could identify risk factors related to the disturbance in ocular microcirculation.
我们使用光相干断层扫描血管造影术（OCTA）研究正常眼压性青光眼患者局部血管密度缺陷（VD）在深层或浅层血管层中的特征。在这项回顾性、横断面研究中，纳入了 74 只存在局部视网膜神经纤维层（RNFL）缺损的眼睛。评估了浅层和深层 VD 宽度与眼部因素之间的关系。深层 VD 较宽的眼睛年龄明显较大（P = 0.023）。OCTA 检查时测量的眼压与深层 VD 的宽度显著相关（P = 0.009）。相比之下，平均神经节细胞内丛状层厚度（GCIPLT）与浅层 VD 的宽度有显著的相关性（P = 0.004）。在逻辑回归分析中，年龄与较宽的深层 VD 明显相关，而平均偏差（MD）较差与较宽的浅层 VD 有显著相关性（P = 0.001，P = 0.003）。总之，虽然浅层的变化似乎是青光眼损害的整体结果，但深层更可能受到与眼微循环相关的因素的影响，如眼压和年龄较大。因此，使用 OCTA 观察深层血管层可以确定与眼微循环紊乱相关的危险因素。
