School of Medicine, New York Medical College, Valhalla, NY, USA.
Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Acta Ophthalmol. 2022 Mar;100(2):e377-e385. doi: 10.1111/aos.14982. Epub 2021 Aug 6.
Biomarkers of ocular blood flow originating from a wide variety of imaging modalities have been associated with glaucoma onset and progression for many decades. Advancements in imaging platforms including optical coherence tomography angiography (OCTA) have provided the ability to quantify vascular changes in glaucoma patients, alongside traditional measures such as retinal nerve fibre layer thickness and optic nerve head structure. Current literature on vascular biomarkers, as measured by OCTA, indicates significant relationships between glaucoma and blood flow and capillary density in the retina and ONH. The data currently available, however, are highly diverse and lack robust longitudinal data on OCTA vascular outcomes and glaucoma progression. Herein we discuss and summarize the relevant current literature on OCTA vascular biomarkers and glaucoma reviewed through March 1, 2021. Associations between OCTA vascular biomarkers and clinical structural and functional glaucoma outcomes as well as differences between glaucoma patients and healthy controls are reviewed and summarized. The available data identify significantly decreased flow density, flow index and vessel density in the ONH, peripapillary vascular layer and macula of glaucoma patients compared with controls. Whole image vessel density is also significantly decreased in glaucoma patients compared with controls, and this outcome has been found to correspond to severity of visual field loss. OCTA vascular biomarkers alongside clinical structural outcomes may aid in assessing overall risk for glaucoma in patients.
几十年来，源自各种成像方式的眼部血流生物标志物一直与青光眼的发生和进展相关。成像平台的进步，包括光相干断层扫描血管造影术（OCTA），使得能够定量评估青光眼患者的血管变化，同时还可以评估视网膜神经纤维层厚度和视神经头结构等传统指标。目前关于 OCTA 测量的血管生物标志物的文献表明，青光眼与视网膜和视神经头的血流和毛细血管密度之间存在显著关系。然而，目前可用的数据高度多样化，缺乏关于 OCTA 血管结果和青光眼进展的可靠纵向数据。本文讨论并总结了截至 2021 年 3 月 1 日有关 OCTA 血管生物标志物和青光眼的相关文献。本文综述了 OCTA 血管生物标志物与临床结构和功能青光眼结果之间的相关性，以及青光眼患者与健康对照者之间的差异。与对照组相比，青光眼患者的视神经头、视盘周围血管层和黄斑区的血流密度、血流指数和血管密度显著降低。与对照组相比，青光眼患者的全图像血管密度也显著降低，并且该结果与视野损失的严重程度相对应。OCTA 血管生物标志物与临床结构结果相结合，可能有助于评估患者的总体青光眼风险。
