Oh Si-Eun, Shin Hee-Jong, Park Chan-Kee, Park Hae-Young Lopilly
Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2023 Jun 22;12(13):4221. doi: 10.3390/jcm12134221.
Superficial and deep macular vessel density (VD) is decreased in eyes with glaucoma. Superficial VD comprises both the retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GC/IPL), and various terms have been used previously to describe the layers of macular VD. In our study, we readjusted the macular segmentation. We obtained RNFL and GC/IPL VDs separately to evaluate VD changes of axon versus soma/dendrite of the retinal ganglion cells (RGCs) in detail. We included 66 eyes of normal tension glaucoma patients with inferior localized RNFL defects solely impacting the inferior hemiretina. Macular VD was measured as RNFL VD and GC/IPL VD. VD ratio was calculated by dividing the VD from the affected hemiretina by the VD from the unaffected hemiretina. RNFL VD ratio was related to RNFL and GC/IPL thicknesses ( 0.005, 0.001), whereas GC/IPL VD ratio was not ( 0.596, 0.783). A lower GC/IPL VD ratio was associated with lower RNFL VD ( 0.017) and systemic hypertension ( 0.03) in multivariate analysis. Patients with a reduced GC/IPL VD ratio were more prone to poor visual field defects ( 0.022) and paracentral scotoma ( 0.046) and more likely to be on treatment for systemic hypertension ( 0.024). Therefore, glaucoma patients on systemic hypertension treatment and reduced GC/IPL VD require cautious management.
青光眼患者的浅表和深层黄斑血管密度（VD）降低。浅表VD包括视网膜神经纤维层（RNFL）和神经节细胞/内网状层（GC/IPL），此前已使用各种术语来描述黄斑VD的各层。在我们的研究中，我们重新调整了黄斑分割。我们分别获得了RNFL和GC/IPL的VD，以详细评估视网膜神经节细胞（RGC）轴突与胞体/树突的VD变化。我们纳入了66只仅影响下半视网膜的低眼压青光眼患者的眼睛，这些患者存在下方局限性RNFL缺损。黄斑VD测量为RNFL VD和GC/IPL VD。VD比值通过将患侧半视网膜的VD除以未患侧半视网膜的VD来计算。RNFL VD比值与RNFL和GC/IPL厚度相关（分别为0.005和0.001），而GC/IPL VD比值则不然（分别为0.596和0.783）。在多变量分析中，较低的GC/IPL VD比值与较低的RNFL VD（P = 0.017）和系统性高血压（P = 0.03）相关。GC/IPL VD比值降低的患者更容易出现不良视野缺损（P = 0.022）和旁中心暗点（P = 0.046），并且更有可能正在接受系统性高血压治疗（P = 0.024）。因此，接受系统性高血压治疗且GC/IPL VD降低的青光眼患者需要谨慎管理。
