Cakir Ihsan, Pehlivanoglu Seren, Yalcinkaya Gulay, Altan Cigdem
Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
J Glaucoma. 2022 Dec 1;31(12):972-978. doi: 10.1097/IJG.0000000000002097. Epub 2022 Aug 9.
The choroidal vascularity index (CVI) is a new marker for the choroid. The decrease in CVI following latanoprost use can provide a better understanding of the pathogenesis of the posterior segment side effects of latanoprost such as cystoid macular edema and central serous choroidopathy.
The purpose of this paper is to evaluate the changes in the CVI, total choroidal area (TCA), stromal area (SA), luminal area (LA), and choroidal thickness (CT) following latanoprost therapy in patients with primary open angle glaucoma and ocular hypertension.
Patients with newly diagnosed primary open angle glaucoma or ocular hypertension who had never received antiglaucoma therapy were included. Each patient received latanoprost 0.005% once daily. Enhanced depth imaging mode of spectral-domain optical coherence tomography scans was taken before the start of latanoprost therapy and in the first and third months. Subfoveal CT, CVI, TCA, LA, and SA for the submacular area, and 4 quadrants of the peripapillary area were calculated from the scans.
A total of 36 eyes of 18 patients were analyzed. Subfoveal CT increased significantly ( P =0.007). Mean TCA ( P =0.008) and SA ( P <0.001) in the first and third months were higher than baseline in the submacular regions. Mean CVI was lower in the first and third months ( P <0.001). There was an increase in the mean TCA and SA in the peripapillary temporal ( P =0.001 and 0.028) and inferior ( P =0.002 and <0.001) quadrants and a decrease in mean CVI in the temporal ( P =0.027) and inferior ( P =0.003) peripapillary quadrants. A negative correlation was found between the rate of decrease in intraocular pressure and the macular region CVI.
Following latanoprost use for several months, the CVI was significantly decreased in newly treated patients with glaucoma or ocular hypertension, among other changes to the choroid. These findings may contribute to a better understanding of the effects of prostaglandins on the posterior segment of the eye.
脉络膜血管指数(CVI)是一种新的脉络膜标志物。使用拉坦前列素后CVI降低,有助于更好地理解拉坦前列素后段副作用(如黄斑囊样水肿和中心性浆液性脉络膜病变)的发病机制。
本文旨在评估原发性开角型青光眼和高眼压症患者接受拉坦前列素治疗后CVI、脉络膜总面积(TCA)、基质面积(SA)、管腔面积(LA)和脉络膜厚度(CT)的变化。
纳入新诊断的、从未接受过抗青光眼治疗的原发性开角型青光眼或高眼压症患者。每位患者每天使用一次0.005%拉坦前列素。在开始使用拉坦前列素治疗前以及治疗后的第一个月和第三个月,进行光谱域光学相干断层扫描的增强深度成像模式检查。从扫描结果中计算黄斑中心凹下CT、CVI、TCA、LA和SA,以及黄斑下区域和视乳头周围区域4个象限的数据。
共分析了18例患者的36只眼。黄斑中心凹下CT显著增加(P = 0.007)。黄斑下区域第一个月和第三个月的平均TCA(P = 0.008)和SA(P < 0.001)高于基线水平。第一个月和第三个月的平均CVI较低(P < 0.001)。视乳头周围颞侧(P = 0.001和0.028)和下方(P = 0.002和<0.001)象限的平均TCA和SA增加,视乳头周围颞侧(P = 0.027)和下方(P = 0.003)象限的平均CVI降低。眼压下降率与黄斑区CVI之间存在负相关。
在新治疗的青光眼或高眼压症患者中,使用拉坦前列素数月后,CVI显著降低,脉络膜还有其他变化。这些发现可能有助于更好地理解前列腺素对眼后段的影响。