Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
Br J Ophthalmol. 2023 Sep;107(9):1286-1294. doi: 10.1136/bjophthalmol-2021-320430. Epub 2022 Jun 20.
To identify clinically relevant parameters for identifying glaucoma in highly myopic eyes, an investigation was conducted of the relationship between the thickness of various retinal layers and the superficial vessel density (sVD) of the macula with axial length (AL) and visual field mean deviation (VFMD).
270 glaucoma patients (438 eyes) participating in the Diagnostic Innovations in Glaucoma cross-sectional study representing three axial myopia groups (non-myopia: n=163 eyes; mild myopia: n=218 eyes; high myopia (AL>26 mm): n=57 eyes) who completed macular optical coherence tomography (OCT) and OCT-angiography imaging were included. Associations of AL and VFMD with the thickness of the ganglion cell inner plexiform layer (GCIPL), macular retinal nerve fibre layer (mRNFL), ganglion cell complex (GCC), macular choroidal thickness (mCT) and sVD were evaluated.
Thinner Global GCIPL and GCC were significantly associated with worse VFMD (R=34.5% and R=32.9%; respectively p<0.001), but not with AL (all p>0.1). Thicker mRNFL showed a weak association with increasing AL (R=2.4%; p=0.005) and a positive association with VFMD (global R=19.2%; p<0.001). Lower sVD was weakly associated with increasing AL (R=1.8%; p=0.028) and more strongly associated with more severe glaucoma VFMD (R=29.6%; p<0.001). Thinner mCT was associated with increasing AL (R=15.5% p<0.001) and not associated with VFMD (p=0.194). mRNFL was thickest while mCT was thinnest in all sectors of high myopic eyes.
As thinner GCIPL and GCC were associated with increasing severity of glaucoma but were not significantly associated with AL, they may be useful for monitoring glaucoma in highly myopic eyes.
为了确定高度近视眼中青光眼的临床相关参数，本研究调查了各视网膜层厚度与黄斑浅层血管密度（sVD）与眼轴（AL）和视野平均偏差（VFMD）之间的关系。
本研究纳入了 270 名参与诊断性青光眼创新横断面研究的青光眼患者（438 只眼），代表三个轴向近视组（非近视：n=163 只眼；轻度近视：n=218 只眼；高度近视（AL>26mm）：n=57 只眼），这些患者完成了黄斑光学相干断层扫描（OCT）和 OCT 血管造影成像。评估了 AL 和 VFMD 与神经节细胞内丛状层（GCIPL）、黄斑视网膜神经纤维层（mRNFL）、神经节细胞复合体（GCC）、黄斑脉络膜厚度（mCT）和 sVD 的厚度之间的关系。
GCIPL 和 GCC 的整体厚度变薄与 VFMD 较差显著相关（R=34.5%和 R=32.9%；p<0.001），但与 AL 无关（均 p>0.1）。mRNFL 较厚与 AL 的增加呈弱相关（R=2.4%；p=0.005），与 VFMD 呈正相关（整体 R=19.2%；p<0.001）。sVD 越低与 AL 的增加呈弱相关（R=1.8%；p=0.028），与更严重的青光眼 VFMD 呈更强相关（R=29.6%；p<0.001）。mCT 变薄与 AL 的增加相关（R=15.5%，p<0.001），与 VFMD 无关（p=0.194）。在高度近视眼的所有象限中，mRNFL 最厚，mCT 最薄。
由于 GCIPL 和 GCC 变薄与青光眼的严重程度增加相关，但与 AL 无显著相关性，因此它们可能有助于监测高度近视眼中的青光眼。
