Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA.
Ophthalmology, Retina, University of California Los Angeles, Los Angeles, CA, USA.
Br J Ophthalmol. 2023 Apr;107(4):505-510. doi: 10.1136/bjophthalmol-2021-320137. Epub 2021 Nov 5.
BACKGROUND/AIMS: To identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG).
We included 315 POAG eyes between 2010 and 2019 with good-quality macular volume scans that had reliable visual fields (VF) available within 6 months in this observational retrospective cohort study. Eyes with retinal pathologies except for epiretinal membrane (ERM) were excluded. The inner nuclear layer was qualitatively assessed for the presence of MME. Global mean deviation (MD) and Visual Field Index (VFI) decay rates, superior and inferior MD rates and pointwise total deviation rates of change were estimated with linear regression. Logistic regression was performed to identify baseline factors associated with the presence of MME and to determine whether MME is associated with progressive VF loss.
25 out of 315 eyes (7.9%) demonstrated MME. The average (±SD) age and MD in eyes with and without MME was 57.2 (±8.7) versus 62.0 (±9.9) years (p=0.02) and -9.8 (±5.7) versus -4.9 (±5.3) dB (p<0.001), respectively. Worse global MD at baseline (p=0.001) and younger age (p=0.02) were associated with presence of MME. ERM was not associated with the presence of MME (p=0.84) in this cohort. MME was not associated with MD and VFI decay rates (p>0.49).
More severe glaucoma and younger age were associated with MME. MME was not associated with faster global VF decay in this cohort. MME may confound monitoring of glaucoma with full macular thickness.
背景/目的：确定原发性开角型青光眼（POAG）患者中与微囊型黄斑水肿（MME）相关的临床特征和因素。
在这项观察性回顾性队列研究中，我们纳入了 2010 年至 2019 年间的 315 只 POAG 眼，这些眼均具有高质量的黄斑容积扫描，并且在 6 个月内可获得可靠的视野（VF）。排除了除视网膜前膜（ERM）以外的视网膜病变的眼睛。定性评估内核层是否存在 MME。使用线性回归估计平均偏差（MD）和视野指数（VFI）衰减率、上下 MD 衰减率和各点总偏差变化率。进行逻辑回归以确定与 MME 存在相关的基线因素，并确定 MME 是否与进行性 VF 损失相关。
在 315 只眼中，有 25 只（7.9%）表现出 MME。在有和没有 MME 的眼中，平均（±SD）年龄和 MD 分别为 57.2（±8.7）岁与 62.0（±9.9）岁（p=0.02）和-9.8（±5.7）dB 与-4.9（±5.3）dB（p<0.001）。基线时更差的全球 MD（p=0.001）和更年轻的年龄（p=0.02）与 MME 的存在相关。在本队列中，ERM 与 MME 的存在无关（p=0.84）。MME 与 MD 和 VFI 衰减率无关（p>0.49）。
更严重的青光眼和更年轻的年龄与 MME 相关。在本队列中，MME 与全球 VF 衰减速度无相关性。MME 可能会混淆对全黄斑厚度的青光眼监测。
