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原发性开角型青光眼和高度近视患者的黄斑及黄斑下脉络膜微血管系统

Macular and submacular choroidal microvasculature in patients with primary open-angle glaucoma and high myopia.

作者信息

Lin Fengbin, Qiu Zhen, Li Fei, Chen Yu, Peng Yuying, Chen Meiling, Song Yunhe, Xiong Jian, Cheng Weijing, Liu Yuhong, Tan Mingkui, Zhang Xiulan, Weinreb Robert

机构信息

Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.

School of Software Engineering, South China University of Technology, Guangzhou, China.

出版信息

Br J Ophthalmol. 2023 May;107(5):650-656. doi: 10.1136/bjophthalmol-2021-319557. Epub 2021 Dec 10.

Abstract

AIMS

To characterise the influence of primary open-angle glaucoma (POAG) and high myopia (HM) on the macular and choroidal capillary density (CD).

METHODS

Two hundred and seven eyes were enrolled, including 80 POAG without HM, 50 POAG with HM, 31 HM without POAG and 46 normal controls. A fovea-centred 6×6 mm optical coherence tomography angiography scan was performed to obtain the CD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris. Macular and choroidal CDs were compared among the groups and the association of CDs with visual field mean deviation (MD) was determined using linear regression models.

RESULTS

Compared with normal eyes, SCP CD was decreased in the POAG without HM group (p<0.05), while DCP CD was significantly decreased in the HM without POAG group (p<0.05). Both SCP and DCP CDs were significantly decreased in the POAG with HM group (p<0.05). CD reduction occurred mainly in the outer rather than inner ring of the 6×6 mm scan size. In multivariate regression analysis, worse MD was associated with lower CD in the outer ring of the SCP in all the HM eyes (p<0.05).

CONCLUSIONS

POAG and HM reduced macular CD in different layers of the retinal capillary plexus and both particularly in the outer ring of the 6×6 mm scans. Furthermore, assessment of the CD in the outer ring of the SCP may facilitate the diagnosis of glaucoma in eyes with HM.

摘要

目的

探讨原发性开角型青光眼(POAG)和高度近视(HM)对黄斑和脉络膜毛细血管密度(CD)的影响。

方法

纳入207只眼,包括80只无高度近视的POAG眼、50只伴有高度近视的POAG眼、31只无POAG的高度近视眼和46只正常对照眼。进行以黄斑中心凹为中心的6×6毫米光学相干断层扫描血管造影,以获取浅表毛细血管丛(SCP)、深层毛细血管丛(DCP)和脉络膜毛细血管的CD。比较各组之间的黄斑和脉络膜CD,并使用线性回归模型确定CD与视野平均偏差(MD)的相关性。

结果

与正常眼相比,无高度近视的POAG组SCP CD降低(p<0.05),而无POAG的高度近视组DCP CD显著降低(p<0.05)。伴有高度近视的POAG组SCP和DCP CD均显著降低(p<0.05)。CD降低主要发生在6×6毫米扫描区域的外环而非内环。在多变量回归分析中,所有高度近视眼中,较差的MD与SCP外环较低的CD相关(p<0.05)。

结论

POAG和HM降低了视网膜毛细血管丛不同层的黄斑CD,尤其是在6×6毫米扫描区域的外环。此外,评估SCP外环的CD可能有助于诊断高度近视眼中的青光眼。

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