开角型青光眼、高度近视和两种疾病并存患者的结构参数差异。一项初步研究。
Differences in structural parameters in patients with open-angle glaucoma, high myopia and both diseases concurrently. A pilot study.
机构信息
Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
出版信息
PLoS One. 2023 Jun 22;18(6):e0286019. doi: 10.1371/journal.pone.0286019. eCollection 2023.
PURPOSE
To evaluate the differences in structural parameters in patients with open-angle glaucoma (OAG), high myopia (M), and both diseases (OAG-M) concurrently.
METHODS
42 subjects with OAG (n = 14), M (n = 14) and OAG-M (n = 14) were included in a prospective pilot study. Mean peripapillary retinal nerve fiber layer (RNFL) thickness, RNFL in superior, temporal, inferior, nasal quadrants, macular ganglion cell complex (GCC) and its' layers, vessel density (VD) of optic nerve head (ONH) and macula were evaluated.
RESULTS
The OAG-M group showed significantly lowest thickness of mean peripapillary RNFL 89 (49-103) μm (p = 0.021), temporal quadrant 64.5 (51-109) μm (p = 0.001) and inferior quadrant 107 (64-124) μm (p = 0.025). The macular RNFL was thinnest in the OAG-M group (p <0.001). Macular VD in inferior quadrant was lowest in OAG-M group at superficial capillary plexus 45.92 (40.39-51.72) % (p = 0.014) and choriocapillaris 51.62 (49.87-56.63) % (p = 0.035). The lowest ONH VD of temporal quadrant was found in the OAG-M group 52.15 (35.73-59.53) % (p = 0.001) in the superficial capillary plexus. Similarly, the lowest VD of inferior quadrant was found in OAG-M group in the choriocapillaris 54.42 (46.31-64.64) % (p<0.001).
CONCLUSIONS
The M group showed the least thinning in the peripapillary RNFL thickness in the temporal quadrant and macular RNFL compared to other two groups. The highest macular VD in the inferior quadrant was in the M group in the superficial capillary plexus, deep capillary plexus and choriocapillaris. The M group showed highest VD in the temporal quadrant and in total VD of ONH at the superficial capillary plexus and in total VD of ONH at the deep capillary plexus.
PRACTICAL RECOMMENDATIONS
The observed decrease in peripapillary RNFL thickness of the temporal quadrant, macular RNFL thickness, the decrease of macular VD at the inferior quadrant and decrease in VD of the ONH temporal quadrant in deep capillary plexus could be beneficial for diagnosing glaucoma in high myopia.
目的
评估开角型青光眼（OAG）、高度近视（M）和同时患有这两种疾病（OAG-M）患者的结构参数差异。
方法
纳入 42 名 OAG 患者（n=14）、M 患者（n=14）和 OAG-M 患者（n=14）进行前瞻性试点研究。评估平均视盘周围视网膜神经纤维层（RNFL）厚度、上方、颞侧、下方和鼻侧象限的 RNFL、黄斑神经节细胞复合体（GCC）及其各层、视神经头（ONH）和黄斑的血管密度（VD）。
结果
OAG-M 组的平均视盘周围 RNFL 厚度最低，为 89（49-103）μm（p=0.021），颞侧象限最低，为 64.5（51-109）μm（p=0.001），下方象限最低，为 107（64-124）μm（p=0.025）。OAG-M 组的黄斑 RNFL 最薄（p<0.001）。OAG-M 组下方象限黄斑浅层毛细血管丛的 VD 最低，为 45.92（40.39-51.72）%（p=0.014），脉络膜毛细血管丛的 VD 最低，为 51.62（49.87-56.63）%（p=0.035）。OAG-M 组颞侧象限 ONH 的 VD 最低，为 52.15（35.73-59.53）%（p=0.001），浅层毛细血管丛。同样，OAG-M 组下方象限脉络膜毛细血管丛的 VD 最低，为 54.42（46.31-64.64）%（p<0.001）。
结论
与其他两组相比，M 组视盘周围 RNFL 颞侧象限和黄斑 RNFL 的变薄程度最小。M 组黄斑下方象限浅层毛细血管丛、深层毛细血管丛和脉络膜毛细血管丛的黄斑 VD 最高。M 组颞侧象限和 ONH 浅层毛细血管丛的总 VD 和深层毛细血管丛的总 ONH 血管密度最高。
实用建议
颞侧象限视盘周围 RNFL 厚度、黄斑 RNFL 厚度、下方象限黄斑 VD 降低、深层毛细血管丛颞侧象限 ONH VD 降低，这些变化可能有助于诊断高度近视性青光眼。
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