Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, Republic of Korea.
Department of Ophthalmology (Y.J., H-Y.L.P., H.S., S.E.O., S.A.K., J-Y.L., D.Y.S., S.J.J., Y-C.K., H-Y.S., J.A.C., N.Y.L., C.K.P.), The Catholic University of Korea, Seoul, Republic of Korea; Seoul St. Mary's Hospital (H-Y.P., H.S., S.E.O., S.A.K., C.K.P.), Seoul, Republic of Korea.
Am J Ophthalmol. 2022 Nov;243:135-148. doi: 10.1016/j.ajo.2022.07.020. Epub 2022 Aug 4.
To investigate the contribution of vessel parameters to identify normal tension glaucoma (NTG) suspects at risk of NTG development.
Multicenter prospective cohort study.
A total of 307 eyes of 307 NTG suspects having intraocular pressure within the normal range; a suspicious optic disc, but without definite localized retinal nerve fiber layer (RNFL) defects; and a normal visual field (VF).
To measure laminar vessel density (VD), the VD was measured in the intradisc region from images of the deep vascular layers of optical coherence tomography angiography (OCT-A). Conversion to NTG was defined either by a new localized RNFL defect in the superotemporal or inferotemporal region, or the presence of a glaucomatous VF defect on 2 consecutive tests according to the pattern deviation plots.
Conversion to NTG.
In total, 73 (23.8%) of the 307 NTG suspects converted to NTG during the follow-up period of 59.84 ± 12.44 months. Detection rate of microvasculature dropout (MvD) was significantly higher in NTG suspects who progressed to NTG (50.7%) than in those who did not (6.4%; P < .001). The macular deep VD (P = .006) and laminar deep VD (P = .004) were significantly lower in NTG suspects who progressed to NTG. The presence of MvD (P < .001) and lower laminar deep VD (P = .006) were significantly associated with NTG conversion.
NTG suspects with baseline MvD or a lower laminar deep VD on OCT-A had a higher risk of conversion.
研究血管参数对识别正常眼压青光眼（NTG）高危疑似患者的作用。
多中心前瞻性队列研究。
共纳入 307 名 NTG 高危疑似患者的 307 只眼，这些患者的眼压在正常范围内；视盘可疑，但无明确局限性视网膜神经纤维层（RNFL）缺损；且视野（VF）正常。
为了测量层状血管密度（VD），从光相干断层扫描血管造影（OCT-A）的深层血管层图像中测量视盘内区域的 VD。根据模式偏差图，将向 NTG 的转化定义为：在上方或下方颞部出现新的局限性 RNFL 缺损，或在 2 次连续检查中出现青光眼 VF 缺损。
向 NTG 的转化。
在随访期间（59.84 ± 12.44 个月），共有 307 名 NTG 高危疑似患者中 73 名（23.8%）转化为 NTG。进展为 NTG 的 NTG 高危疑似患者中微血管缺失（MvD）的检出率（50.7%）显著高于未进展为 NTG 的患者（6.4%；P <.001）。进展为 NTG 的 NTG 高危疑似患者的黄斑深层 VD（P =.006）和层状深层 VD（P =.004）显著降低。存在 MvD（P <.001）和较低的层状深层 VD（P =.006）与 NTG 转化显著相关。
OCT-A 基线时存在 MvD 或较低的层状深层 VD 的 NTG 高危疑似患者转化为 NTG 的风险更高。
