Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; University of California, San Diego, La Jolla, California.
Ophthalmol Glaucoma. 2022 Nov-Dec;5(6):648-657. doi: 10.1016/j.ogla.2022.06.004. Epub 2022 Jun 13.
To investigate the relationship of longitudinal changes in macular vessel density (VD) from OCT angiography and in ganglion cell complex (GCC) from OCT with central visual field (VF) in eyes with early glaucoma.
Observational cohort.
A total of 95 eyes, 37 preperimetric and 58 with early glaucoma (24-2 VF mean deviation [MD] ≥ -6 decibels), with an average follow-up of 3.8 years and 5.3 visits, were included.
Whole-image VD (wiVD) and whole-image GCC (wiGCC) and parafoveal scans, as well as localized regions of interest (LROIs), hemiretinae of whole images, and superior, inferior, temporal, and nasal sectors of parafoveal maps, were matched with central VF locations. Age-adjusted rates of change of VD, GCC, mean sensitivity of VF locations, and 10-2 VF MD were calculated using linear mixed-effect models. Normalized rates of change were calculated for comparison of change rates in wiVD and wiGCC.
Structure-function (SF) correlations of VD and GCC with central VF measurement change rates and comparison of different correlations of SF relationships after bootstrapping the difference of the correlation coefficients.
Vessel density loss and GCC thinning demonstrated significant correlations with central VF damage, globally and with most LROIs. The SF correlation (r, 95% confidence interval [CI]) between wiVD and 10-2 VF MD change rates was 0.42 [0.24, 0.58], whereas it was 0.27 [0.08, 0.45] between wiGCC and 10-2 VF MD changes rates (all P < 0.05). In contrast to GCC thinning, VD loss in the parafoveal sectors demonstrated significant correlations with central VF damage in inferior and temporal sectors. Differences in the relationship of SF with central VF damage were not significant between VD loss and GCC thinning. The mean (95% CI) normalized change rates of wiVD (-7.40 [-7.71 to 7.09] %/year) was faster than that of wiGCC (-2.39 [-2.94 to 1.84] %/year) (P < 0.05).
Rates of VD loss and GCC thinning are associated with central VF loss over time. Assessment of both macular VD and GCC thickness should be considered for evaluation of glaucoma progression.
研究从 OCT 血管造影获得的黄斑血管密度（VD）和从 OCT 获得的神经节细胞复合体（GCC）的纵向变化与早期青光眼患者中央视野（VF）的关系。
观察性队列研究。
共纳入 95 只眼，37 只前期青光眼和 58 只早期青光眼（24-2VF 平均缺损[MD]≥-6 分贝），平均随访 3.8 年，共 5.3 次就诊。
全像 VD（wiVD）和全像 GCC（wiGCC）以及旁黄斑扫描，以及局部感兴趣区域（LROI）、全像半视网膜、旁黄斑图的上、下、颞和鼻象限，与中央 VF 位置相匹配。使用线性混合效应模型计算 VD、GCC、VF 位置平均敏感度和 10-2VF MD 的年龄校正变化率。为了比较 wiVD 和 wiGCC 的变化率，计算了归一化变化率。
VF 测量变化率与 VD 和 GCC 的结构-功能（SF）相关性，以及在 bootstrap 差异相关系数后比较 SF 关系的不同相关性。
血管密度丧失和 GCC 变薄与中央 VF 损伤具有显著相关性，在全局和大多数 LROI 中均如此。wiVD 与 10-2VF MD 变化率的 SF 相关性（r，95%置信区间[CI]）为 0.42[0.24，0.58]，而 wiGCC 与 10-2VF MD 变化率的 SF 相关性为 0.27[0.08，0.45]（均 P<0.05）。与 GCC 变薄相比，旁黄斑区 VD 丧失与中央 VF 在下、颞区的损伤具有显著相关性。SF 与中央 VF 损伤之间的关系在 VD 丧失和 GCC 变薄之间没有显著差异。wiVD（-7.40[-7.71 至 7.09]%/年）的平均（95%CI）归一化变化率快于 wiGCC（-2.39[-2.94 至 1.84]%/年）（P<0.05）。
VD 丧失和 GCC 变薄的速率与中央 VF 的随时间损失有关。评估黄斑 VD 和 GCC 厚度都应考虑用于评估青光眼的进展。
