Yoon Jooyoung, Sung Kyung Rim, Shin Joong Won
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul 05505, Korea.
J Clin Med. 2021 Dec 14;10(24):5862. doi: 10.3390/jcm10245862.
The aim of this study was to determine the factors associated with visual field (VF) deterioration after trabeculectomy, including the peripapillary vessel density (pVD) and macular vessel density (mVD) changes assessed by optical coherence tomography angiography (OCT-A). Primary open-angle glaucoma patients with more than two years of follow-up after trabeculectomy were included. pVD was calculated in a region defined as a 750 μm-wide elliptical annulus extending from the optic disc boundary. mVD was calculated in the parafoveal (1-3 mm) and perifoveal (3-6 mm) regions. VF deterioration was defined as the rate of mean deviation (MD) worse than -1.5 dB/year. The change rates of pVD and mVD were compared between the deteriorated VF and non-deteriorated VF groups. The factors associated with the rate of MD were determined by linear regression analyses. VF deterioration was noted in 14 (21.5%) of the 65 eyes that underwent trabeculectomy. The pVD (-2.26 ± 2.67 vs. -0.02 ± 1.74%/year, ≤ 0.001) reduction rate was significantly greater in the deteriorated VF group than in the non-deteriorated VF group, while that of parafoveal ( = 0.267) and perifoveal ( = 0.350) VD did not show a significant difference. The linear regression analysis showed that the postoperative MD reduction rate was significantly associated with the rate of pVD reduction ( = 0.016), while other clinical parameters and preoperative vascular parameters did not show any association. Eyes with greater loss of peripapillary retinal circulation after trabeculectomy tended to exhibit VF deterioration. The assessment of peripapillary vascular status can be an adjunctive strategy to predict visual function after trabeculectomy.
本研究的目的是确定小梁切除术后与视野（VF）恶化相关的因素，包括通过光学相干断层扫描血管造影（OCT-A）评估的视乳头周围血管密度（pVD）和黄斑血管密度（mVD）变化。纳入小梁切除术后随访超过两年的原发性开角型青光眼患者。pVD在从视盘边界延伸的750μm宽的椭圆形环区域内计算。mVD在黄斑旁（1-3mm）和黄斑周围（3-6mm）区域计算。VF恶化定义为平均偏差（MD）速率比-1.5dB/年更差。比较恶化VF组和未恶化VF组之间pVD和mVD的变化率。通过线性回归分析确定与MD速率相关的因素。在接受小梁切除术的65只眼中，有14只（21.5%）出现VF恶化。恶化VF组的pVD降低率（-2.26±2.67 vs. -0.02±1.74%/年，P≤0.001）显著高于未恶化VF组，而黄斑旁（P = 0.267）和黄斑周围（P = 0.350）VD的降低率无显著差异。线性回归分析表明，术后MD降低率与pVD降低率显著相关（P = 0.016），而其他临床参数和术前血管参数无相关性。小梁切除术后视乳头周围视网膜循环损失更大的眼睛往往表现出VF恶化。对视乳头周围血管状态的评估可以作为预测小梁切除术后视觉功能的辅助策略。
