Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.
Invest Ophthalmol Vis Sci. 2023 Aug 1;64(11):6. doi: 10.1167/iovs.64.11.6.
PURPOSE: To assess the clinical characteristics of focal temporal optic disc microvasculature dropout (MvD-D) in primary open-angle glaucoma (POAG) patients. METHODS: One hundred and eighty-seven eyes of 187 POAG patients having MvD-D on Swept-Source optical coherence tomography angiography (SS-OCTA) were enrolled. Three groups were categorized according to the presence of temporal MvD-D within the upper and lower 45° of the fovea-Bruch's membrane (BM) opening axis: focal temporal MvD-D (Group 1, isolated focal temporal MvD-D; 44 eyes), supero/inferotemporal MvD-D (Group 2, MvD-D only in superotemporal or inferotemporal sector; 78 eyes), and diffuse temporal MvD-D (Group 3, MvD-D spanning ≥ 2 consecutive sectors, at least one of which being temporal sector; 65 eyes). RESULTS: Group 1 had a significantly longer axial length and β-zone parapapillary atrophy without BM. There also was a larger horizontal tilt angle and ovality index than the other two groups (P < 0.001). Group 1 had a significantly thinner retinal nerve fiber layer (RNFL) in the temporal sector than did Group 2 (P < 0.001), despite similar thicknesses in all other areas (P > 0.05). Group 3 had significantly worse visual field mean deviation and thinner RNFL than the other two groups in all areas other than the nasal, temporal, and superotemporal sectors (P < 0.05). CONCLUSIONS: Focal temporal MvD-D detected by SS-OCTA was associated with a longer axial length and related subsequent morphological changes of the optic disc and parapapillary area. This suggests that stretching of the optic disc consequent on axial elongation may lead to absence of temporal optic disc microvasculature.
目的:评估原发性开角型青光眼(POAG)患者中局灶性颞侧视盘微血管丢失(MvD-D)的临床特征。
方法:纳入了 187 例经扫频源光学相干断层扫描血管造影(SS-OCTA)检查发现 MvD-D 的 POAG 患者的 187 只眼。根据在黄斑-脉络膜(BM)开口轴上下 45°范围内颞侧 MvD-D 的存在情况,将这些眼分为三组:局灶性颞侧 MvD-D(组 1,孤立性局灶性颞侧 MvD-D;44 只眼)、上/下颞侧 MvD-D(组 2,仅在上颞或下颞象限存在 MvD-D;78 只眼)和弥漫性颞侧 MvD-D(组 3,MvD-D 跨越≥2 个连续象限,至少一个为颞侧象限;65 只眼)。
结果:组 1 的眼轴明显较长,β 区视盘旁萎缩且无 BM。其水平倾斜角和椭圆度指数也明显大于其他两组(P<0.001)。尽管其他所有区域的厚度相似,但组 1 的颞侧象限视网膜神经纤维层(RNFL)明显比组 2 薄(P<0.001)。组 3 在所有除鼻侧、颞侧和上颞侧象限外的区域的平均视野缺损和 RNFL 厚度均明显差于其他两组(P<0.05)。
结论:SS-OCTA 检测到的局灶性颞侧 MvD-D 与较长的眼轴长度以及视盘和视盘旁区的相关后续形态变化有关。这表明轴向伸长引起的视盘拉伸可能导致颞侧视盘微血管缺失。
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