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视盘小凹周围浅表微血管的象限分析

Topographic Quadrant Analysis of Peripapillary Superficial Microvasculature in Optic Disc Drusen.

作者信息

Yan Yan, Zhou Xiao, Chu Zhongdi, Stell Laurel, Shariati Mohammad Ali, Wang Ruikang K, Liao Yaping Joyce

机构信息

Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, United States.

Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Neurol. 2021 May 19;12:666359. doi: 10.3389/fneur.2021.666359. eCollection 2021.

Abstract

Limited information is known about the topographic effect of optic disc drusen (ODD) on peripapillary retinal nerve fibers and microvasculature. This study aims to understand the structural and functional impact of ODD in different quadrants of the optic disc. We performed a retrospective case-control study of 22 ODD patients (34 eyes) and 26 controls (33 eyes) to compare optical coherence tomography (OCT) retinal nerve fiber layer (RNFL), OCT angiography (OCTA), and corresponding static perimetry mean deviation (MD) calculated using the modified Garway-Heath map in different quadrants of the optic disc. OCTA was analyzed using custom MATLAB script to measure six parameters in a peripapillary annulus with large vessel removal: vessel area density (VAD), vessel skeleton density (VSD), vessel perimeter index (VPI), vessel complexity index (VCI), flux, and vessel diameter index (VDI). Quadrant analysis revealed that OCTA VAD and VCI were significantly decreased in superior, nasal, and inferior but not temporal quadrant. RNFL, VSD, and VPI were significantly impacted only in the superior and nasal quadrants. Corresponding visual field MDs in all ODD eyes were not different in the four quadrants, although eyes with MD equal or worse than -5 dB (32%) had worst visual field corresponding to the superior quadrant of the optic disc (inferior arcuate visual field). Structure-structure comparison of OCT and OCTA showed high correlation of RNFL with multiple OCTA measurements in the superior, nasal, and inferior quadrants but not temporal quadrant. Structure-function analysis revealed significant correlation of VAD and VCI and visual field MD in every quadrant, but RNFL was only significantly correlated in the superior and inferior quadrants. Peripapillary VAD and VCI are decreased in more quadrants than RNFL, supporting the clinical utility of performing OCTA in addition to OCT. Consistent with the most common locations of ODD, five OCT/OCTA measurements (VAD, VCI, RNFL, VSD, VPI) are decreased in the superior and nasal quadrants. OCT/OCTA measurements were significantly impacted in contrast to the relatively mild effect on corresponding visual field MD, consistent with the idea that a decrease in structural and vascular measurements occurs without parallel change in visual function in ODD.

摘要

关于视盘玻璃疣(ODD)对视乳头周围视网膜神经纤维和微血管的地形学影响,目前所知信息有限。本研究旨在了解ODD对视盘不同象限的结构和功能影响。我们对22例ODD患者(34只眼)和26例对照者(33只眼)进行了一项回顾性病例对照研究,以比较光学相干断层扫描(OCT)视网膜神经纤维层(RNFL)、OCT血管造影(OCTA)以及使用改良的Garway-Heath图谱计算的视盘不同象限对应的静态视野平均偏差(MD)。使用自定义的MATLAB脚本分析OCTA,以测量去除大血管的视乳头周围环形区域的六个参数:血管面积密度(VAD)、血管骨架密度(VSD)、血管周长指数(VPI)、血管复杂性指数(VCI)、血流量和血管直径指数(VDI)。象限分析显示,OCTA的VAD和VCI在上方、鼻侧和下方象限显著降低,但在颞侧象限未降低。RNFL、VSD和VPI仅在上方和鼻侧象限受到显著影响。所有ODD眼的相应视野MD在四个象限中没有差异,尽管MD等于或低于-5 dB的眼(32%)在视盘上方象限(下方弓形视野)对应的视野最差。OCT和OCTA结构-结构比较显示,RNFL与上方、鼻侧和下方象限的多个OCTA测量值高度相关,但与颞侧象限无关。结构-功能分析显示,每个象限中VAD和VCI与视野MD均存在显著相关性,但RNFL仅在上方和下方象限显著相关。视乳头周围VAD和VCI降低的象限比RNFL更多,这支持了除OCT外还进行OCTA的临床实用性。与ODD最常见的位置一致,上方和鼻侧象限的五个OCT/OCTA测量值(VAD、VCI、RNFL、VSD、VPI)降低。与对视野MD的相对轻微影响相比,OCT/OCTA测量值受到显著影响,这与ODD中结构和血管测量值降低而视觉功能无平行变化的观点一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e525/8170317/93b87078b6b0/fneur-12-666359-g0001.jpg

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