Luo Man, Zhu Yingting, Xiao Hui, Huang Jingjing, Ling Jin, Huang Haishun, Li Yiqing, Zhuo Yehong
State Key Laboratory of Ophthalmology, Guangzhou 510060, China.
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
J Clin Med. 2022 Mar 16;11(6):1661. doi: 10.3390/jcm11061661.
This study aimed to analyze the quantitative vascular biomarkers of filtering bleb function at different depths using anterior segment optical coherence tomography angiography (AS-OCTA). This cross-sectional study is registered on Clinicaltrails.gov (NCT04515017). Forty-six eyes with primary open-angle glaucoma that had undergone trabeculectomy with mitomycin-C for more than six months were included. Vessel density (VD) and vessel diameter index (VDI) in the superficial layer (SL), Tenon's layer (TL), and deep layer (DL) of the bleb were obtained. The VD and VDI were higher in the failure group (both = 0.000). Significant correlations were found between the SL, TL, DL's VDI, and IOP in the success group ( = 0.013, 0.016, 0.031, respectively). The VD of the TL and DL were related to IOP in the failure group ( = 0.012, 0.009). Tenon's VD (TVD) and Tenon's VDI (TVDI) correlated with IOP adjusting for TVD, TVDI, and the Indiana Bleb Appearance Grading Scale (IBAGS) ( = 0.009, 0.043) or Kenfeld grading system (KGS) ( = 0.011, 0.016). The area under curve (AUC) of the TVD, TVDI, IBAGS, and KGS to predict surgery failure were 0.960, 0.925, 0.770, and 0.850. AS-OCTA realized the quantitative evaluation of vessels, especially the invisible vascularity beneath the conjunctiva. TVD and TVDI as detected by AS-OCTA better reflected bleb function than conventional grading systems.
本研究旨在使用眼前节光学相干断层扫描血管造影（AS-OCTA）分析不同深度滤过泡功能的定量血管生物标志物。这项横断面研究已在Clinicaltrails.gov（NCT04515017）上注册。纳入了46只接受丝裂霉素C小梁切除术超过6个月的原发性开角型青光眼患者的眼睛。获取滤过泡表层（SL）、Tenon囊层（TL）和深层（DL）的血管密度（VD）和血管直径指数（VDI）。失败组的VD和VDI更高（均P = 0.000）。成功组中SL、TL、DL的VDI与眼压之间存在显著相关性（分别为P = 0.013、0.016、0.031）。失败组中TL和DL的VD与眼压相关（P = 0.012、0.009）。调整TVD、TVDI和印第安纳滤过泡外观分级量表（IBAGS）后，Tenon囊VD（TVD）和Tenon囊VDI（TVDI）与眼压相关（P = 0.009、0.043），或与Kenfeld分级系统（KGS）相关（P = 0.011、0.016）。TVD、TVDI、IBAGS和KGS预测手术失败的曲线下面积（AUC）分别为0.960、0.925、0.770和0.850。AS-OCTA实现了对血管的定量评估，尤其是结膜下不可见血管。AS-OCTA检测到的TVD和TVDI比传统分级系统更能反映滤过泡功能。
