Fan Xintong, Xu Huan, Zhai Ruyi, Sheng Qilian, Sun Yanan, Shao Tingting, Kong Xiangmei
Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Front Med (Lausanne). 2022 Mar 18;9:850483. doi: 10.3389/fmed.2022.850483. eCollection 2022.
To evaluate peripapillary vascular reactivity in primary open-angle glaucoma (POAG) with and without high myopia (HM) by using optical coherence tomography angiography (OCTA).
This prospective study enrolled 48 eyes with POAG, including 16 and 32 eyes with and without HM, respectively. The retinal peripapillary vessel density (VD) was repeatedly assessed using OCTA at baseline and after a hyperoxia test (breathing 80% oxygen). The VD changes between different oxygenation conditions were calculated to reflect the vasoreactivity. Linear regression was performed to determine the relationship between myopia and retinal vascular reactivity in patients with POAG. Systemic hemodynamic characteristics were also evaluated under both conditions.
The VD was significantly reduced after hyperoxia in the whole image (baseline and hyperoxia: 41.4 ± 4.5 and 38.8 ± 4.4, respectively, < 0.001) and in the peripapillary regions (44.3 ± 5.7 and 41.1 ± 5.4, respectively, < 0.001) in POAG eyes without HM. However, in eyes with HM, the whole-image VD in hyperoxia was not significantly different from the baseline (baseline and hyperoxia: 40.5 ± 6.2 and 40.2 ± 6.2, respectively, = 0.481). The VD changes in eyes with HM were significantly smaller than those in eyes without HM in both the whole image (0.3 ± 1.8 and 2.6 ± 2.0, respectively, < 0.001) and peripapillary regions (1.1 ± 2.0 and 3.2 ± 2.3, respectively, = 0.003). Linear regression results showed a significant correlation between retinal vascular reactivity and spherical equivalent (SE) (β = 0.28, < 0.001, = 0.31) and axial length (AL) (β = -0.72, < 0.001, = 0.33).
Retinal vasoreactivity of peripapillary capillaries in POAG eyes with HM was significantly impaired in comparison with that in POAG eyes without HM. A lower peripapillary vascular response was significantly associated with worse SE and elongated AL.
通过光学相干断层扫描血管造影（OCTA）评估有无高度近视（HM）的原发性开角型青光眼（POAG）患者的视乳头周围血管反应性。
这项前瞻性研究纳入了48只POAG眼，其中分别有16只和32只伴有和不伴有HM。在基线和高氧试验（呼吸80%氧气）后，使用OCTA反复评估视网膜视乳头周围血管密度（VD）。计算不同氧合条件下的VD变化以反映血管反应性。进行线性回归以确定POAG患者近视与视网膜血管反应性之间的关系。同时评估两种条件下的全身血流动力学特征。
在不伴有HM的POAG眼中，高氧后全图像（基线和高氧时分别为41.4±4.5和38.8±4.4，<0.001）和视乳头周围区域（分别为44.3±5.7和41.1±5.4，<0.001）的VD显著降低。然而，在伴有HM的眼中，高氧时的全图像VD与基线无显著差异（基线和高氧时分别为40.5±6.2和40.2±6.2，=0.481）。在全图像（分别为0.3±1.8和2.6±2.0，<0.001）和视乳头周围区域（分别为1.1±2.0和3.2±2.3，=0.003）中，伴有HM的眼的VD变化均显著小于不伴有HM的眼。线性回归结果显示视网膜血管反应性与球镜等效度（SE）（β=0.28，<0.001，=0.31）和眼轴长度（AL）（β=-0.72，<0.001，=0.33）之间存在显著相关性。
与不伴有HM的POAG眼相比，伴有HM的POAG眼视乳头周围毛细血管的视网膜血管反应性显著受损。较低的视乳头周围血管反应与较差的SE和延长的AL显著相关。
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