假性剥脱性青光眼中的动脉血流动力学及其与视网膜微结构的相关性。
Arterial hemodynamics and its correlation with retinal microarchitecture in pseudoexfoliation glaucoma.
作者信息
Kocaturk Tolga, Abdullayev Ozge Key, Bekmez Sinan, Polat Yasemin Durum
机构信息
Department of Ophthalmology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey.
Department of Ophthalmology, Aydin State Hospital, Aydin, Turkey.
出版信息
Arq Bras Oftalmol. 2022 May 9;86(5):e20230065. doi: 10.5935/0004-2749.20230065. eCollection 2022.
PURPOSE
The study aimed to investigate the correlation between arterial hemodynamics measured by color Doppler ultrasonography and retinal microarchitecture parameters determined by spectral-domain optical coherence tomography (SD-OCT) in pseudoexfoliation glaucoma.
METHODS
This prospective study included 82 participants. Peripapillary retinal nerve fiber layer, ganglion cell inner plexiform layer, and ganglion cell complex values were measured. Ophthalmic artery and central retinal artery flows were evaluated with color Doppler ultrasonography, and resistivity index values were calculated.
RESULTS
The study included 47 controls and 35 pseudoexfoliation glaucoma cases. In pseudoexfoliation glaucoma group, mean peripapillary retinal nerve fiber layer and ganglion cell complex thickness were statistically significantly lower in all quadrants compared to controls (p<0.001). Resistivity index values of the ophthalmic and central retinal arteries were significantly higher in pseudoexfoliation glaucoma group than in the controls (p<0.001 and r=0.684). Resistivity index values of the ophthalmic and central retinal arteries with ganglion cell complex thickness correlated significantly. On the other hand, no significant relationship for retinal nerve fiber layer thickness was identified.
CONCLUSIONS
Structural changes (ganglion cell complex and ganglion cell inner plexiform layer) in patients with pseudoexfoliation glaucoma and early glaucomatous loss showed a significant correlation with changes in ocular vascular hemodynamics. In cases where systemic vascular resistance is increased, ganglion cell complex and ganglion cell inner plexiform layer may not exactly reflect glaucoma state. In such cases, thickness changes in the retinal nerve fiber layer may give more realistic results regarding glaucoma. We have seen that pseudoexfoliation glaucoma-induced structural deterioration and increased resistance in ocular hemodynamics correlated with ganglion cell complex, but not retinal nerve fiber layer.
目的
本研究旨在探讨在假性剥脱性青光眼中，彩色多普勒超声测量的动脉血流动力学与光谱域光学相干断层扫描（SD-OCT）测定的视网膜微结构参数之间的相关性。
方法
这项前瞻性研究纳入了82名参与者。测量了视乳头周围视网膜神经纤维层、神经节细胞内丛状层和神经节细胞复合体的值。用彩色多普勒超声评估眼动脉和视网膜中央动脉的血流，并计算阻力指数值。
结果
该研究包括47名对照者和35例假性剥脱性青光眼患者。在假性剥脱性青光眼组中，与对照组相比，所有象限的平均视乳头周围视网膜神经纤维层和神经节细胞复合体厚度在统计学上显著更低（p<0.001）。假性剥脱性青光眼组的眼动脉和视网膜中央动脉的阻力指数值显著高于对照组（p<0.001，r=0.684）。眼动脉和视网膜中央动脉的阻力指数值与神经节细胞复合体厚度显著相关。另一方面，未发现与视网膜神经纤维层厚度有显著关系。
结论
假性剥脱性青光眼患者的结构变化（神经节细胞复合体和神经节细胞内丛状层）以及早期青光眼性损害与眼部血管血流动力学变化显著相关。在全身血管阻力增加的情况下，神经节细胞复合体和神经节细胞内丛状层可能无法准确反映青光眼状态。在这种情况下，视网膜神经纤维层的厚度变化可能会给出关于青光眼的更实际结果。我们发现，假性剥脱性青光眼引起的结构恶化和眼部血流动力学阻力增加与神经节细胞复合体相关，但与视网膜神经纤维层无关。
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