Köse Helin Ceren, Tekeli Oya
Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
Photodiagnosis Photodyn Ther. 2022 Dec;40:103114. doi: 10.1016/j.pdpdt.2022.103114. Epub 2022 Sep 10.
To investigate and compare the peripapillary and macular microvascular parameters between eyes with primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCTA).
Seventy-nine eyes of 43 patients with primary angle closure glaucoma (PACG), 78 eyes of 43 patients with primary open-angle glaucoma (POAG), 64 eyes of 35 patients with primary angle closure (PAC), and 73 eyes of 40 control subjects underwent imaging with OCTA. Perfusion density (PD) and vessel density (VD) for the macular area, and PD and flux index (FI) for the peripapillary area were calculated automatically. The area under receiver operator characteristic curves (AUC) were constructed to distinguish PACG and POAG eyes from healthy control eyes.
The peripapillary FI in all quadrants and PD and VD of the macular outer circle in superior and inferior quadrants were significantly lower in PACG and POAG eyes than in control eyes. The peripapillary FI in the inferior quadrant was significantly lower in the POAG group than in the PACG group (0.348 ± 0.06 vs. 0.369 ± 0.06, p = 0.04). The remaining OCTA parameters in the peripapillary and macular area did not show a significant difference between the POAG and PACG groups. Eyes with PAC presented significantly lower PD and VD than healthy control eyes at the superior and inferior quadrant of the macular outer circle, while retinal nerve fiber layer and ganglion cell inner complex thickness were not significantly different from than control eyes. The best diagnostic parameter was peripapillary FI in both PACG (AUC: 0.922) and POAG (AUC: 0.938) eyes.
We found significantly lower peripapillary FI in the inferior quadrant in POAG eyes compared to the PACG eyes, which may indicate the different underlying pathogenesis between POAG and PACG. The PAC eyes had lower macular PD and VD than normal eyes. This suggests that retinal vascular impairment may develop earlier than structural damage in PAC eyes.
使用光学相干断层扫描血管造影（OCTA）研究并比较原发性闭角型青光眼（PACG）和原发性开角型青光眼（POAG）患者眼部的视乳头周围和黄斑微血管参数。
43例原发性闭角型青光眼（PACG）患者的79只眼、43例原发性开角型青光眼（POAG）患者的78只眼、35例原发性闭角（PAC）患者的64只眼以及40名对照者的73只眼接受了OCTA成像。自动计算黄斑区的灌注密度（PD）和血管密度（VD），以及视乳头周围区域的PD和血流指数（FI）。构建受试者操作特征曲线下面积（AUC）以区分PACG和POAG患眼与健康对照眼。
PACG和POAG患眼所有象限的视乳头周围FI以及上、下象限黄斑外圆的PD和VD均显著低于对照眼。POAG组下象限的视乳头周围FI显著低于PACG组（0.348±0.06对0.369±0.06，p = 0.04）。POAG组和PACG组视乳头周围和黄斑区的其余OCTA参数无显著差异。PAC患者黄斑外圆上、下象限的PD和VD显著低于健康对照眼，而视网膜神经纤维层和神经节细胞内复合体厚度与对照眼无显著差异。PACG（AUC：0.922）和POAG（AUC：0.938）患眼中最佳诊断参数均为视乳头周围FI。
我们发现POAG患眼下象限的视乳头周围FI显著低于PACG患眼，这可能表明POAG和PACG的潜在发病机制不同。PAC患眼的黄斑PD和VD低于正常眼。这表明PAC患眼中视网膜血管损伤可能比结构损伤更早出现。
