From Narayana Nethralaya (H.L.R., S.D., N.K.P.), Hulimavu, Bangalore, India; University Eye Clinic Maastricht (H.L.R., C.A.B.W), University Medical Center, Maastricht, the Netherlands.
From Narayana Nethralaya (H.L.R., S.D., N.K.P.), Hulimavu, Bangalore, India.
Am J Ophthalmol. 2022 Jan;233:171-179. doi: 10.1016/j.ajo.2021.07.023. Epub 2021 Jul 25.
To evaluate the association between optical microangiography (OMAG) measurements and progressive retinal nerve fiber layer (RNFL) loss in primary open angle glaucoma (POAG).
Prospective case series.
Sixty-four eyes of 40 patients with POAG (108 quadrants) with mild to moderate functional damage were longitudinally studied for at least 2 years and with a minimum of 3 optical coherence tomography examinations. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, sex, presence of systemic diseases, central corneal thickness, presence of disc hemorrhage, and mean and fluctuation of intraocular pressure during follow-up), baseline hemifield mean deviation, baseline quadrant optical coherence tomography RNFL and ganglion cell inner plexiform layer thickness), and OMAG (peripapillary and macular perfusion density [PD] and vessel density [VD]) on the rate of RNFL change was evaluated using linear mixed models.
Average (±SD) mean deviation, RNFL, and ganglion cell inner plexiform layer thickness of the analyzed quadrants at baseline were -5.5 ± 2.9 dB, 96.5 ± 17.9 µm, and 73.8 ± 8.6 µm, respectively. Peripapillary PD and VD in the quadrant were 44.6% ± 5.9% and 17.5 ± 2.2 mm/mm, respectively. Rate of quadrant RNFL change was -1.8 ± 0.6 µm/y. Multivariate mixed models showed that lower peripapillary PD (coefficient = 0.08, P = .01) and lower VD (coefficient = 0.21, P = .02) were significantly associated with a faster rate of RNFL loss.
Lower baseline peripapillary PD and VD measured using OMAG were significantly associated with a faster rate of RNFL loss in POAG. OMAG imaging provides useful information about the risk of glaucoma progression and the rate of disease worsening.
评估光学微脉管造影（OMAG）测量值与原发性开角型青光眼（POAG）中进行性视网膜神经纤维层（RNFL）丢失之间的关系。
前瞻性病例系列。
对至少 2 年且至少进行了 3 次光学相干断层扫描检查的 40 例 POAG 患者（108 象限）的 64 只眼进行了纵向研究。在基线就诊时进行 OMAG 成像。使用线性混合模型评估临床参数（年龄、性别、是否存在系统性疾病、中央角膜厚度、视盘出血情况以及随访期间的平均眼压和眼压波动）、基线半视野平均偏差、基线象限光学相干断层扫描 RNFL 和神经节细胞内丛状层厚度）和 OMAG（视盘周围和黄斑灌注密度 [PD] 和血管密度 [VD]）对 RNFL 变化率的影响。
分析象限的平均（±标准差）平均偏差、RNFL 和神经节细胞内丛状层厚度在基线时分别为-5.5 ± 2.9 dB、96.5 ± 17.9 µm 和 73.8 ± 8.6 µm。象限内的视盘周围 PD 和 VD 分别为 44.6% ± 5.9%和 17.5 ± 2.2 mm/mm。象限 RNFL 变化率为-1.8 ± 0.6 µm/y。多变量混合模型显示，较低的视盘周围 PD（系数=0.08，P=.01）和较低的 VD（系数=0.21，P=.02）与较快的 RNFL 丢失率显著相关。
使用 OMAG 测量的较低的视盘周围 PD 和 VD 与 POAG 中较快的 RNFL 丢失率显著相关。OMAG 成像提供了有关青光眼进展风险和疾病恶化速度的有用信息。
