Chen Xuhao, Hong Ying, Di Haohao, Wu Qianru, Zhang Di, Zhang Chun
Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China.
Front Med (Lausanne). 2021 Dec 9;8:730327. doi: 10.3389/fmed.2021.730327. eCollection 2021.
To investigate the relationship between retinal microvasculature changes and intraocular pressure (IOP) for ocular hypertension (OHT) patients and further assess the factors associated with retinal microcirculation changes. This was a single-center prospective study designed for OHT patients, which consisted of two visits. After collecting baseline data of those who met the eligibility criteria, these patients were treated with latanoprost 0.005% ophthalmic solution for 4 weeks. Peripapillary vessel density (VD) of radial peripapillary capillaries (RPC) layer, macular VD in both superficial and deep layers, and foveal avascular zone (FAZ) area were measured by optical coherence tomography angiography (OCTA) before and after the treatment. We compared the changes in IOP and VD among the two visits by paired-sample -test. Bonferroni correction was applied. Factors associated with VD changes were analyzed by linear regression analysis. Thirty-four eyes of thirty-four patients were included. The mean IOP decreased by 6.5 ± 2.2 mmHg ( < 0.001). The peripapillary RPC VD increased significantly from 51.8 ± 2.5 to 53.0 ± 3.1% (Adjusted- = 0.012). We found no significant difference in detailed sectors of the peripapillary region after correction. In the macular area, both the superficial and deep layers in foveal (superficial: 0.2 ± 1.9%, = 0.523; deep: 0.0 ± 2.3%, = 0.969) and parafoveal (superficial: 0.3 ± 3.0%, = 0.565; deep: 0.5 ± 3.1%, = 0.423) VD remained unchanged. The decrease of the mean FAZ area was insignificant ( = 0.295). The percentage of IOP reduction (β = 0.330, = 0.031) and the baseline RNFL thickness (β = 0.450, = 0.004) significantly correlated with the percentage of peripapillary RPC VD improvement in the multivariate linear regression analysis. The peripapillary VD in OHT patients increased after the reduction of IOP. The mild change of IOP did not alter the microcirculation in the macula. In addition, the percentage of IOP change and the baseline RNFL thickness were independent factors for the peripapillary RPC VD improvement.
为研究高眼压症（OHT）患者视网膜微血管变化与眼压（IOP）之间的关系，并进一步评估与视网膜微循环变化相关的因素。这是一项针对OHT患者的单中心前瞻性研究，包括两次就诊。在收集符合入选标准患者的基线数据后，这些患者使用0.005%拉坦前列素滴眼液治疗4周。通过光学相干断层扫描血管造影（OCTA）测量治疗前后视乳头周围放射状毛细血管（RPC）层的视乳头周围血管密度（VD）、黄斑浅层和深层的黄斑VD以及中心凹无血管区（FAZ）面积。我们通过配对样本t检验比较两次就诊时IOP和VD的变化。应用Bonferroni校正。通过线性回归分析分析与VD变化相关的因素。纳入了34例患者的34只眼。平均IOP降低了6.5±2.2 mmHg（P<0.001）。视乳头周围RPC VD从51.8±2.5%显著增加至53.0±3.1%（校正后P = 0.012）。校正后，我们发现视乳头周围区域的详细扇区无显著差异。在黄斑区，中心凹（浅层：0.2±1.9%，P = 0.523；深层：0.0±2.3%，P = 0.969）和旁中心凹（浅层：0.3±3.0%，P = 0.565；深层：0.5±3.1%，P = 0.423）浅层和深层的VD均无变化。平均FAZ面积的减小不显著（P = 0.295）。在多变量线性回归分析中，IOP降低百分比（β = 0.330，P = 0.031）和基线视网膜神经纤维层（RNFL）厚度（β = 0.450，P = 0.004）与视乳头周围RPC VD改善百分比显著相关。OHT患者视乳头周围VD在IOP降低后增加。IOP的轻微变化未改变黄斑区的微循环。此外，IOP变化百分比和基线RNFL厚度是视乳头周围RPC VD改善的独立因素。
