Department of Ophthalmology at the Shiley Eye Institute, University of California at San Diego, La Jolla, California, USA.
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Br J Ophthalmol. 2024 Feb 21;108(3):372-379. doi: 10.1136/bjo-2022-322234.
To characterise the relationship between a deep-layer microvasculature dropout (MvD) and central visual field (VF) damage in primary open-angle glaucoma (POAG) patients with and without high axial myopia.
Cross-sectional study.
Seventy-one eyes (49 patients) with high axial myopia and POAG and 125 non-highly myopic POAG eyes (97 patients) were enrolled. Presence, area and angular circumference of juxtapapillary MvD were evaluated on optical coherence tomography angiography B-scans and en-face choroidal images.
Juxtapapillary MvD was detected more often in the highly myopic POAG eyes (43 eyes, 86%) than in the non-highly myopic eyes (73 eyes, 61.9%; p=0.002). In eyes with MvD, MvD area and angular circumference (95% CI) were significantly larger in the highly myopic eyes compared with the non-highly myopic eyes (area: (0.69 (0.40, 0.98) mm vs 0.31 (0.19, 0.42) mm, p=0.011) and (angular circumference: 84.3 (62.9, 105.8) vs 74.5 (58.3, 90.9) degrees, p<0.001), respectively. 24-2 VF mean deviation (MD) was significantly worse in eyes with MvD compared with eyes without MvD in both groups (p<0.001). After adjusting for 24-2 MD VF, central VF defects were more frequently found in eyes with MvD compared with eyes without MvD (82.7% vs 60.9%, p<0.001). In multivariable analysis, higher intraocular pressure, worse 24-2 VF MD, longer axial length and greater MvD area and angular circumference were associated with worse 10-2 VF MD.
MvD was more prevalent and larger in POAG eyes with high myopia than in non-highly myopic POAG eyes. In both groups, eyes with MvD showed worse glaucoma severity and more central VF defects.
描述伴有和不伴有高度轴性近视的原发性开角型青光眼（POAG）患者深层微血管丢失（MvD）与中央视野（VF）损害之间的关系。
横断面研究。
纳入 71 只眼（49 例患者）伴高度轴性近视和 POAG 以及 125 只非高度近视 POAG 眼（97 例患者）。在光学相干断层扫描血管造影 B 扫描和脉络膜面像上评估视盘旁 MvD 的存在、面积和角周界。
高度近视 POAG 眼中（43 只眼，86%）视盘旁 MvD 的检出频率高于非高度近视眼中（73 只眼，61.9%；p=0.002）。在存在 MvD 的眼中，高度近视眼中 MvD 的面积和角周界（95%CI）显著大于非高度近视眼中（面积：（0.69（0.40，0.98）mm 比 0.31（0.19，0.42）mm，p=0.011）和（角周界：84.3（62.9，105.8）比 74.5（58.3，90.9）度，p<0.001）。两组中 MvD 眼的 24-2 视野平均偏差（MD）均显著差于无 MvD 眼（p<0.001）。在调整 24-2 视野 MD 后，MvD 眼比无 MvD 眼更常发现中央视野缺损（82.7%比 60.9%，p<0.001）。多变量分析显示，较高的眼压、更差的 24-2 视野 MD、更长的眼轴长度以及更大的 MvD 面积和角周界与更差的 10-2 视野 MD 相关。
与非高度近视 POAG 眼相比，高度近视 POAG 眼中 MvD 更常见且更大。在两组中，MvD 眼的青光眼严重程度更差，中央视野缺损更多。
