眼压与青光眼黄斑变薄率。
Intraocular Pressure and Rates of Macular Thinning in Glaucoma.
机构信息
Vision, Imaging, and Performance Laboratory, Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Biology, University of North Carolina, Chapel Hill, North Carolina.
Vision, Imaging, and Performance Laboratory, Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina.
出版信息
Ophthalmol Glaucoma. 2023 Sep-Oct;6(5):457-465. doi: 10.1016/j.ogla.2023.03.008. Epub 2023 Apr 8.
PURPOSE
To evaluate the effect of intraocular pressure (IOP) on the rates of macular thickness (ganglion cell layer [GCL] and ganglion cell-inner plexiform layer [GCIPL]) change over time measured by spectral-domain (SD) OCT.
DESIGN
Retrospective cohort study.
PARTICIPANTS
Overall, 451 eyes of 256 patients with primary open-angle glaucoma.
METHODS
Data were extracted from the Duke Ophthalmic Registry, a database of electronic medical records of patients observed under routine clinical care at the Duke Eye Center, and satellite clinics. All records from patients with a minimum of 6 months of follow-up and at least 2 good-quality Spectralis SD-OCT macula scans were included. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of GCL and GCIPL thickness change over time.
MAIN OUTCOME MEASURES
The effect of IOP on the rates of GCL and GCIPL thickness loss measured by SD-OCT.
RESULTS
Eyes had a mean follow-up of 1.8 ± 1.3 years, ranging from 0.5 to 10.2 years. The average rate of change for GCL thickness was -0.220 μm/year (95% confidence interval [CI], -0.268 to -0.172 μm/year) and for GCIPL thickness was -0.231 μm/year (95% CI, -0.302 to -0.160 μm/year). Each 1-mmHg higher mean IOP during follow-up was associated with an additional loss of -0.021 μm/year of GCL thickness (P = 0.001) and -0.032 μm/year of GCIPL thickness (P = 0.001) after adjusting for potentially confounding factors, such as baseline age, disease severity, sex, race, central corneal thickness, and follow-up time.
CONCLUSIONS
Higher IOP was significantly associated with faster rates of GCL and GCIPL loss over time measured by SD-OCT, even during relatively short follow-up times. These findings support the use of SD-OCT GCL and GCIPL thickness measurements as structural biomarkers for the evaluation of the efficacy of IOP-lowering therapies in slowing down the progression of glaucoma.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的
评估眼内压（IOP）对通过谱域（SD）OCT 测量的随时间变化的黄斑厚度（神经节细胞层[GCL]和神经节细胞内丛状层[GCIPL]）变化率的影响。
设计
回顾性队列研究。
参与者
共有 256 名原发性开角型青光眼患者的 451 只眼。
方法
从杜克眼科登记处提取数据，这是一个在杜克眼科中心和卫星诊所接受常规临床护理观察的患者电子病历数据库。所有至少随访 6 个月且至少有 2 次高质量 Spectralis SD-OCT 黄斑扫描的患者记录均包含在内。线性混合模型用于研究随访期间平均 IOP 与随时间推移 GCL 和 GCIPL 厚度变化率之间的关系。
主要观察指标
SD-OCT 测量的 GCL 和 GCIPL 厚度损失率受 IOP 的影响。
结果
眼的平均随访时间为 1.8±1.3 年，范围为 0.5 至 10.2 年。GCL 厚度的平均变化率为-0.220 μm/年（95%置信区间[CI]：-0.268 至-0.172 μm/年），GCIPL 厚度为-0.231 μm/年（95% CI：-0.302 至-0.160 μm/年）。随访期间平均 IOP 每升高 1mmHg，GCL 厚度的损失就会额外增加-0.021 μm/年（P=0.001），GCIPL 厚度的损失会额外增加-0.032 μm/年（P=0.001），调整了潜在混杂因素，如基线年龄、疾病严重程度、性别、种族、中央角膜厚度和随访时间。
结论
即使在相对较短的随访时间内，较高的 IOP 与 SD-OCT 测量的 GCL 和 GCIPL 随时间的损失率显著相关，这支持使用 SD-OCT GCL 和 GCIPL 厚度测量作为评估降低眼压疗法减缓青光眼进展的结构生物标志物。
金融披露
本文末尾的脚注和披露中可能包含专有或商业披露信息。
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