Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Br J Ophthalmol. 2023 Apr;107(4):540-546. doi: 10.1136/bjophthalmol-2021-319675. Epub 2021 Nov 5.
To determine the relationship of various systemic and ocular characteristics with perifoveal and macular vessel density in healthy African American eyes.
A population-based cross-sectional study of prospectively recruited African Americans ≥40 years of age. Participants underwent 3×3 mm and 6×6 mm macula scans using spectral-domain optical coherence tomography angiography (OCTA), clinical examinations and clinical questionnaires. Participants with glaucoma, severe non-proliferative diabetic retinopathy, proliferative diabetic retinopathy and macular oedema were excluded. Custom MATLAB based software quantified vessel area density (VAD) and vessel skeleton density (VSD) in the superficial retinal layer of the macula. Multivariable regression analysis, controlling for inter-eye correlation, was performed to determine systemic and ocular determinants of macular vessel metrics using stepwise selection. Candidate variables included: age, gender, body mass index, history of smoking, history of diabetes, diabetes duration, history of stroke or brain haemorrhage, systolic blood pressure, diastolic blood pressure (DBP), pulse pressure, mean arterial pressure, central subfield thickness (CSFT), visual field mean deviation, intraocular pressure, axial length (AL), mean ocular perfusion pressure and signal strength (SS).
A total of 2221 OCTA imaged eyes from 1472 participants were included in this study. Reduced perifoveal and macular VAD and VSD were independently associated with longer AL, reduced SS, reduced CSFT and older age. Male gender and lower DBP were also associated with reduced perifoveal and macular VSD.
When interpreting OCTA images in a clinical setting, it is important to consider the effects ocular and systemic characteristics may have on the macular microcirculation.
确定各种系统性和眼部特征与健康非裔美国人的周边和黄斑血管密度的关系。
这是一项基于人群的前瞻性招募非裔美国人（年龄≥40 岁）的横断面研究。参与者接受了 3×3mm 和 6×6mm 黄斑扫描，使用了频域光相干断层扫描血管造影（OCTA）、临床检查和临床问卷调查。排除青光眼、严重非增殖性糖尿病视网膜病变、增殖性糖尿病视网膜病变和黄斑水肿患者。使用基于 MATLAB 的定制软件对黄斑浅层的血管面积密度（VAD）和血管骨架密度（VSD）进行量化。使用逐步选择的方法，通过多变量回归分析，控制眼间相关性，确定系统性和眼部决定因素与黄斑血管指标的关系。候选变量包括：年龄、性别、体重指数、吸烟史、糖尿病史、糖尿病病程、中风或脑出血史、收缩压、舒张压（DBP）、脉压、平均动脉压、中央视网膜神经纤维层厚度（CSFT）、视野平均偏差、眼内压、眼轴长度（AL）、平均眼灌注压和信号强度（SS）。
本研究共纳入了来自 1472 名参与者的 2221 只 OCTA 成像眼。周边和黄斑 VAD 和 VSD 的减少与较长的 AL、较低的 SS、较小的 CSFT 和较老的年龄独立相关。男性性别和较低的 DBP 也与周边和黄斑 VSD 的减少相关。
在临床环境中解读 OCTA 图像时，重要的是要考虑眼部和系统性特征对黄斑微循环可能产生的影响。
