Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey.
Department of Chest Diseases, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey.
Indian J Ophthalmol. 2022 May;70(5):1669-1677. doi: 10.4103/ijo.IJO_2338_21.
To evaluate the retinal and optic disc microvascular changes according to disease severity in patients with stable chronic obstructive pulmonary disease (COPD), and the correlation of pulmonary parameters with optical coherence tomography angiography (OCTA) findings.
Forty patients with COPD and 30 age- and sex-matched subjects (control group) were included in this cross-sectional prospective study. The COPD group was then divided into two subgroups according to GOLD classification and disease severity as mild-to-moderate COPD group (group 1) and severe COPD group (group 2). OCTA was performed with 6 mm × 6 mm sections for the macula and 4.5 mm × 4.5 mm sections for the optic disc. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, and vessel density in different sections of the retina and optic disc were analyzed.
The mean ages, gender, intraocular pressures, peripapillary RNFL thickness, FRT, and optic disc vessel densities were similar among the groups. Compared to the control group and group 1, group 2 showed significantly lower mean foveal vessel density measurements in superficial and deep capillary plexus (P = 0.014 and P = 0.007, respectively). Cigarette packets/year, exacerbation per year, and Modified Medical Research Council showed significant negative correlations, whereas forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed significant positive correlations with foveal vessel densities.
COPD severity seems to have a negative effect on OCTA measurements. OCTA may reflect the severity of inflammation and hypoxia in COPD and may provide useful detailed information on the role of retinal vascular changes in the follow-up and progression of patients with COPD.
根据稳定期慢性阻塞性肺疾病（COPD）患者的疾病严重程度评估视网膜和视盘微血管变化，并分析与光学相干断层扫描血管造影（OCTA）结果相关的肺参数。
本横断面前瞻性研究纳入了 40 名 COPD 患者和 30 名年龄和性别匹配的对照者（对照组）。根据 GOLD 分类和疾病严重程度将 COPD 组分为轻度至中度 COPD 组（组 1）和重度 COPD 组（组 2）。使用 6mm×6mm 黄斑区和 4.5mm×4.5mm 视盘区 OCTA 进行检查。分析视网膜和视盘不同节段的黄斑中心视网膜厚度（FRT）、视盘周围视网膜神经纤维层（RNFL）厚度和血管密度。
三组间的平均年龄、性别、眼内压、视盘周围 RNFL 厚度、FRT 和视盘血管密度无显著差异。与对照组和组 1 相比，组 2 浅层和深层毛细血管丛的黄斑中心平均血管密度明显降低（P=0.014 和 P=0.007）。吸烟包/年、每年急性加重次数和改良医学研究委员会呼吸困难评分与黄斑中心血管密度呈显著负相关，而 1 秒用力呼气量（FEV1）和 FEV1/用力肺活量与黄斑中心血管密度呈显著正相关。
COPD 严重程度似乎对视 OCTA 测量结果有负面影响。OCTA 可能反映了 COPD 中炎症和缺氧的严重程度，并可能为视网膜血管变化在 COPD 患者随访和疾病进展中的作用提供有用的详细信息。
