From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
Am J Ophthalmol. 2022 May;237:193-203. doi: 10.1016/j.ajo.2021.11.018. Epub 2021 Nov 19.
To evaluate the association of macular superficial vessel density (SVD) and projection-resolved deep vessel density (DVD) with past visual field (VF) progression in patients with primary open-angle glaucoma.
Retrospective cohort.
In this longitudinal study, 208 eyes of 147 patients with glaucoma from the Diagnostics Innovations in Glaucoma Study were included. Eligible participants were required to have at least five 24-2 VF tests over a minimum follow-up period of 3 years before macular optical coherence tomography angiography imaging. VF progression was defined based on both event-based pointwise linear regression and trend-based methods. The association of macular SVD and DVD with the probability and rate of past VF progression was evaluated using a linear mixed effects model.
Fifty-two (25%) eyes had VF progression based on the pointwise linear regression based criterion at the end of a mean ± standard deviation follow-up duration of 6.9 ± 1.2 years. In the event-based multivariable analysis, a lower baseline SVD was associated with a higher likelihood of past VF progression (odds ratio per 1% lower. 1.28; 95% confidence interval, 1.02-1.59). Similarly, in the trend-based multivariable analysis, lower macular SVD was associated with a faster past rate of mean deviation decline (coefficient = -0.03 dB/year; 95% confidence interval, -0.04 to -0.01). Event-based and trend-based analyses found no significant associations for macular DVD with the likelihood/rate of past VF progression (P > .05).
Lower macular SVD, and not DVD, was associated with a higher probability of past VF progression. Macular optical coherence tomography angiography imaging shows promise for identifying eyes at risk of VF progression in patients with glaucoma.
评估黄斑浅层血管密度（SVD）和投影分辨深层血管密度（DVD）与原发性开角型青光眼患者过去视野（VF）进展的关系。
回顾性队列研究。
在这项纵向研究中，纳入了来自诊断学创新青光眼研究的 147 名患者的 208 只眼。合格的参与者必须在黄斑光学相干断层扫描血管造影成像前至少有 5 次 24-2VF 测试，随访时间至少 3 年。VF 进展是基于基于事件的逐点线性回归和基于趋势的方法来定义的。使用线性混合效应模型评估黄斑 SVD 和 DVD 与过去 VF 进展概率和速率的关系。
52 只（25%）眼根据平均±标准偏差随访时间为 6.9±1.2 年的逐点线性回归基于事件的标准，在终点时有 VF 进展。在基于事件的多变量分析中，较低的基线 SVD 与过去 VF 进展的可能性更高相关（每降低 1%的优势比为 1.28；95%置信区间，1.02-1.59）。同样，在基于趋势的多变量分析中，较低的黄斑 SVD 与过去平均偏差下降速度更快相关（系数为-0.03dB/年；95%置信区间，-0.04 至-0.01）。基于事件和基于趋势的分析发现黄斑 DVD 与过去 VF 进展的可能性/速率无显著相关性（P>.05）。
较低的黄斑 SVD，而不是 DVD，与过去 VF 进展的可能性更高相关。黄斑光学相干断层扫描血管造影成像有望识别青光眼患者 VF 进展风险较高的眼睛。
