疑似青光眼患者眼部的黄斑厚度及微血管损失
Macular Thickness and Microvasculature Loss in Glaucoma Suspect Eyes.
作者信息
Hou Huiyuan, Moghimi Sasan, Kamalipour Alireza, Ekici Eren, Oh Won Hyuk, Proudfoot James A, El-Nimri Nevin, Penteado Rafaella C, Nishida Takashi, David Ryan C, Weinreb Robert N
机构信息
Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.
出版信息
Ophthalmol Glaucoma. 2022 Mar-Apr;5(2):170-178. doi: 10.1016/j.ogla.2021.07.009. Epub 2021 Jul 30.
PURPOSE
To characterize the change of ganglion cell complex (GCC) thickness and macular vessel density in glaucoma suspect eyes with ocular hypertension (OHT) or glaucomatous optic neuropathy (GON).
DESIGN
Prospective, longitudinal study.
PARTICIPANTS
Eight-three eyes (24 healthy, 30 OHT, and 29 GON) of 65 patients who underwent at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was at least 3 years.
METHODS
OCT angiography (OCTA)-based vessel density and OCT-based structural thickness of the 3 × 3-mm GCC scan slab were evaluated at each visit. The rates of vessel density and thickness change were compared across diagnostic groups using a linear mixed-effects model.
MAIN OUTCOME MEASURES
Change rates of macula GCC thickness and superficial vessel density.
RESULTS
Significant mean rates of both GCC thinning and vessel density loss were detectable in OHT and GON groups. Of the individual suspect eyes, 49.1% showed significant loss (P < 0.05) with either vessel density or GCC thickness. Of the GON eyes, 31.0% showed both significant GCC loss and vessel density loss, 51.7% showed only significant GCC loss, whereas 17.2% showed only significant vessel density loss. Vessel density loss was faster than GCC thinning in half of the suspect eyes based on percent loss analysis. The age and scan quality-adjusted GCC thinning rates of the OHT group (-0.59 μm/year; P = 0.025) and GON group (-0.79 μm/year; P = 0.058) were faster than those of the healthy group (-0.11 μm/year), whereas the rate of vessel density loss was not significantly different among the diagnostic groups (all P > 0.2). Higher mean intraocular pressure during follow-up was associated with faster GCC thinning in the OHT group (P = 0.065) and GON groups (P = 0.015), but was not associated with the rate of vessel density decrease.
CONCLUSIONS
Whereas the rate of GCC thinning was faster on average in suspect eyes than in healthy eyes, some suspect eyes showed significant loss of vessel density and faster vessel density loss than GCC thinning. OCT and OCTA are complementary and useful for evaluating eyes with OHT or GON.
目的
描述高眼压（OHT）或青光眼性视神经病变（GON）的青光眼可疑眼中神经节细胞复合体（GCC）厚度和黄斑血管密度的变化。
设计
前瞻性纵向研究。
参与者
从青光眼诊断创新研究中纳入了65例患者的83只眼（24只健康眼、30只OHT眼和29只GON眼），这些患者至少接受了3次随访。平均随访时间至少为3年。
方法
每次随访时评估基于光学相干断层扫描血管造影（OCTA）的3×3 mm GCC扫描区域的血管密度以及基于光学相干断层扫描（OCT）的结构厚度。使用线性混合效应模型比较不同诊断组之间血管密度和厚度的变化率。
主要观察指标
黄斑GCC厚度和表层血管密度的变化率。
结果
在OHT组和GON组中均检测到GCC变薄和血管密度降低的显著平均变化率。在个体可疑眼中，49.1%的眼在血管密度或GCC厚度方面出现显著降低（P<0.05）。在GON眼中，31.0%的眼同时出现显著的GCC降低和血管密度降低，51.7%的眼仅出现显著的GCC降低，而17.2%的眼仅出现显著的血管密度降低。根据百分比降低分析，在一半的可疑眼中，血管密度降低比GCC变薄更快。OHT组（-0.59μm/年；P = 0.025）和GON组（-0.79μm/年；P = 0.058）经年龄和扫描质量调整后的GCC变薄率比健康组（-0.11μm/年）更快，而不同诊断组之间血管密度降低率无显著差异（所有P>0.2）。随访期间较高的平均眼压与OHT组（P = 0.065）和GON组（P = 0.015）中更快的GCC变薄相关，但与血管密度降低率无关。
结论
虽然可疑眼的GCC变薄率平均比健康眼更快，但一些可疑眼出现了显著的血管密度降低，且血管密度降低比GCC变薄更快。OCT和OCTA对于评估OHT或GON眼是互补且有用的。
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