Van Eijgen Jan, Heintz Alexander, van der Pluijm Claire, Delporte Margaux, De Witte Dries, Molenberghs Geert, Barbosa-Breda João, Stalmans Ingeborg
Department of Neurosciences, Research Group of Ophthalmology, KU Leuven, Leuven, Belgium.
Department of Ophthalmology, University Hospitals UZ Leuven, Leuven, Belgium.
Front Med (Lausanne). 2023 Jan 6;9:1037471. doi: 10.3389/fmed.2022.1037471. eCollection 2022.
PURPOSE: Vascular dysregulation seems to play a role in the pathogenesis of glaucoma, in particular normal tension glaucoma (NTG). The development of optical coherence tomography angiography (OCTA) enabled the measurement of the retinal microvasculature non-invasively and with high repeatability. Nonetheless, only a few studies transformed OCTA into a dynamic examination employing a sympathomimetic stimulus. The goal of this study was to use this dynamic OCTA exam (1) to differentiate healthy individuals from glaucoma patients and (2) to distinguish glaucoma subcategories, NTG and high-tension primary open angle glaucoma (POAG). METHODS: Retinal vessel density (VD) in NTG patients ( = 16), POAG patients ( = 12), and healthy controls ( = 14) was compared before and during a hand grip test with a hydraulic dynamometer. RESULTS: At baseline, mean peripapillary VD was lower in POAG and NTG (42.6 and 48.5%) compared to healthy controls (58.1%; < 0.001) and higher in NTG compared to POAG ( = 0.024) when corrected for mean arterial pressure (MAP). Peripapillary and macular (superficial and deep) VD differences were found for gender, age, and baseline MAP. No change in VD occurred (pre-/post-stimulus) in any of the groups. CONCLUSION: Retinal VD loss in glaucoma patients was confirmed and the necessity to correct for gender, age and especially MAP was established. Although replication in a larger population is necessary, OCTA might not be the most suitable method to dynamically evaluate the retinal microvasculature.
目的:血管调节异常似乎在青光眼,尤其是正常眼压性青光眼(NTG)的发病机制中起作用。光学相干断层扫描血管造影(OCTA)技术的发展使得能够以非侵入性且高重复性的方式测量视网膜微血管系统。尽管如此,仅有少数研究将OCTA转变为采用拟交感神经刺激的动态检查。本研究的目的是利用这种动态OCTA检查(1)区分健康个体与青光眼患者,以及(2)区分青光眼亚类,即NTG和高眼压性原发性开角型青光眼(POAG)。 方法:使用液压测力计进行握力测试前及测试过程中,比较NTG患者(n = 16)、POAG患者(n = 12)和健康对照者(n = 14)的视网膜血管密度(VD)。 结果:在基线时,校正平均动脉压(MAP)后,POAG和NTG患者的平均视乳头周围VD低于健康对照者(分别为42.6%和48.5%,对照者为58.1%;P < 0.001),且NTG患者的视乳头周围VD高于POAG患者(P = 0.024)。视乳头周围以及黄斑(浅层和深层)VD在性别、年龄和基线MAP方面存在差异。所有组在刺激前后VD均未发生变化。 结论:证实了青光眼患者存在视网膜VD降低,并确定了校正性别、年龄尤其是MAP的必要性。尽管需要在更大规模人群中进行重复研究,但OCTA可能并非动态评估视网膜微血管系统的最合适方法。
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