青光眼患者的眼血流和脉络膜厚度。

Ocular blood flow and choroidal thickness in ocular hypertension.

机构信息

Clinic of Ophthalmology, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

, Ankara, Turkey.

出版信息

Int Ophthalmol. 2022 May;42(5):1357-1368. doi: 10.1007/s10792-021-02123-2. Epub 2021 Nov 25.

Abstract

PURPOSE

Ocular hypertension (OHT) is a clinical entity characterized by elevated intraocular pressure (IOP) without optic nerve damage. In the presence of other risk factors, OHT may progress to glaucoma. This study aimed to evaluate ocular blood flow (OBF) and choroidal thickness (CT), which may be markers and/or risk factors that could assess the progression of OHT to glaucoma.

MATERIAL AND METHODS

Age and gender matched 60 eyes of 32 patients with OHT and 61 eyes of 31 control patients were included for this study. All participants underwent a detailed ophthalmological examination including best-corrected visual acuity, IOP measurement with Goldmann applanation tonometry, gonioscopy, optic nerve evaluation with 78 D lens, and visual field test with Humphrey visual field analyzer. Retinal nerve fiber layer, ganglion cell complex, and central corneal thickness measurements were performed by optical coherence tomography (OCT). CT was measured with OCT in the fovea, 1.5 mm, 2 mm, 2.5 mm nasal and temporal to the fovea and from nasal and temporal to the optic disk. OBF data including peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI) were measured with color Doppler imaging (CDI) from the ophthalmic artery (OA), central retinal artery (CRA), medial and lateral branches of short posterior ciliary arteries (MPCA, LPCA). Systolic (SBP) and diastolic arterial blood pressure were also noted.

RESULTS

CT measurement at each point in the OHT group compared to the control group were found to be significantly thinner (p = 0.001). There was a decrement in CT from the fovea to the nasal and temporal retina in both groups. In the OHT group, there was a significant decrease in PSV and EDV of OA, CRA, MPCA, and LPCA, and a significant increase in PI and RI of measured arteries. (EDV p = 0.036, PI p = 0.006, RI p = 0.006 for OA and p = 0.001 for other arteries and all OBF measurements). There was a negative correlation between CT and age, IOP and axial length (AL) in OHT group (r = - 0.529, p = 0.001; r = - 0.258, p = 0.047; r = - 0.345, p = 0.007, respectively, for fovea). But there was no statistically significant correlation between CT and other measurements in the control group, except age (r = - 0.860 p = 0.001 for fovea).

CONCLUSION

We found that OBF decrement and choroidal thinning in OHT group compared with controls. Interpretation both of CT measurements with OCT and OBF parameters with CDI and new imaging technologies may help to prevent and reduce the possible optic nerve damage.

摘要

目的

眼压升高(OHT)是一种临床实体,其特征是眼内压(IOP)升高而没有视神经损伤。在存在其他危险因素的情况下,OHT 可能进展为青光眼。本研究旨在评估眼血流(OBF)和脉络膜厚度(CT),它们可能是评估 OHT 进展为青光眼的标志物和/或危险因素。

材料和方法

本研究纳入了 32 例 OHT 患者的 60 只眼和 31 例对照组患者的 61 只眼,这些患者年龄和性别相匹配。所有参与者均接受详细的眼科检查,包括最佳矫正视力、Goldmann 压平眼压计测量眼压、房角镜检查、78 D 透镜评估视神经和 Humphrey 视野分析仪进行视野检查。通过光学相干断层扫描(OCT)测量视网膜神经纤维层、节细胞复合体和中央角膜厚度。通过 OCT 在黄斑、1.5mm、2mm、2.5mm 鼻侧和颞侧黄斑以及鼻侧和颞侧视神经测量 CT。使用彩色多普勒成像(CDI)从眼动脉(OA)、中央视网膜动脉(CRA)、短睫状后动脉的内侧和外侧分支(MPCA、LPCA)测量 OBF 数据,包括收缩期峰值速度(PSV)、舒张末期速度(EDV)、阻力指数(RI)和搏动指数(PI)。还记录了收缩压(SBP)和舒张压的动脉血压。

结果

与对照组相比,OHT 组各部位 CT 测量值明显变薄(p=0.001)。两组 CT 从黄斑向鼻侧和颞侧视网膜逐渐变薄。在 OHT 组,OA、CRA、MPCA 和 LPCA 的 PSV 和 EDV 显著降低,而测量动脉的 PI 和 RI 显著增加(EDV p=0.036,PI p=0.006,RI p=0.006 对于 OA 和所有 OBF 测量值的 p=0.001)。OHT 组 CT 与年龄、眼压和眼轴(AL)呈负相关(r=-0.529,p=0.001;r=-0.258,p=0.047;r=-0.345,p=0.007,分别为黄斑)。但是在对照组中,除了年龄(黄斑 r=-0.860,p=0.001)外,CT 与其他测量值之间没有统计学上的显著相关性。

结论

与对照组相比,我们发现 OHT 组的 OBF 减少和脉络膜变薄。用 OCT 测量 CT 测量值和用 CDI 测量 OBF 参数以及新的成像技术可能有助于预防和减少可能的视神经损伤。

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