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原发性先天性青光眼的光学相干断层扫描血管造影的视盘周围和黄斑血管参数。

Peripapillary and macular vascular parameters by optical coherence tomography angiography in primary congenital glaucoma.

机构信息

Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain.

Hospital Universitario Quiron, Pozuelo, Madrid, Spain.

出版信息

Eye (Lond). 2023 Feb;37(2):267-273. doi: 10.1038/s41433-021-01919-x. Epub 2022 Jan 10.

Abstract

OBJECTIVE

To evaluate the differences in peripapillary and macular vascular parameters by optical coherence tomography angiography (OCTA) between patients with primary congenital glaucoma (PCG) and healthy controls; and to determine their diagnostic accuracy.

MATERIAL AND METHODS

Observational, cross-sectional study including 39 eyes with PCG and 78 healthy eyes. Only one eye per patient was included. All included patients underwent a comprehensive ophthalmic examination and peripapillary and macular analysis were performed by Angioplex OCTA (Cirrus HD-OCT 5000) with a 4.5 × 4.5 mm optic nerve head scan and 6 × 6 mm macular scan. Global data and quadrant data from peripapillary vascular parameters and global data and circular sectors data from macular superficial plexus parameters were compared between groups. The glaucoma discrimination capability of these parameters was calculated as areas under the receiver operating characteristics curve (AUC ROC).

RESULTS

Mean age was 14.1 ± 8.7 years for the PCG patients and 11.7 ± 6.2 years for controls (p = 0.093). All vascular peripapillary measurements (global and quadrants; all p < 0.001) and all macular measurements (p < 0.042) excepting perfusion density in the inner circle (p = 0.087), were reduced in the PCG group compared to controls. According to AUC ROC, peripapillary (all ≥ 0.706) and macular parameters (all ≥ 0.699) showed good diagnostic capacity. AUC ROC for the most discriminatory measurements corresponding to blood flux index (0.887) and whole macula vascular density (0.855) were similar (p = 0.085).

CONCLUSION

Peripapillary and macular vascular parameters by OCTA are decreased in patients with PCG, showing a good capacity to discriminate between normal and glaucomatous eyes.

摘要

目的

通过光学相干断层扫描血管造影术(OCTA)评估原发性先天性青光眼(PCG)患者与健康对照者的视乳头和黄斑血管参数差异,并确定其诊断准确性。

材料与方法

本研究为观察性、横断面研究,纳入 39 只 PCG 眼和 78 只健康眼。每位患者仅纳入一眼。所有纳入患者均行全面眼科检查,通过 Angioplex OCTA(Cirrus HD-OCT 5000)行视乳头和黄斑分析,视神经头扫描面积为 4.5×4.5mm,黄斑扫描面积为 6×6mm。比较两组间视乳头血管参数的整体和象限数据以及黄斑浅层脉络膜参数的整体和环形扇区数据。计算这些参数的青光眼鉴别能力,即受试者工作特征曲线下面积(AUC ROC)。

结果

PCG 患者的平均年龄为 14.1±8.7 岁,对照组为 11.7±6.2 岁(p=0.093)。与对照组相比,PCG 组所有视乳头血管测量值(整体和象限;均 p<0.001)和所有黄斑测量值(除内圈血流密度外,p=0.087)均降低。根据 AUC ROC,视乳头(均≥0.706)和黄斑参数(均≥0.699)具有良好的诊断能力。对应血流指数(0.887)和整个黄斑血管密度(0.855)的最具鉴别力的测量值的 AUC ROC 相似(p=0.085)。

结论

OCTA 检测的视乳头和黄斑血管参数在 PCG 患者中降低,对正常眼和青光眼眼具有良好的鉴别能力。

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本文引用的文献

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A Review of OCT Angiography in Glaucoma.青光眼的光学相干断层扫描血管造影综述
Semin Ophthalmol. 2019;34(4):279-286. doi: 10.1080/08820538.2019.1620807. Epub 2019 Jun 3.

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