Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2023 Sep 1;64(12):10. doi: 10.1167/iovs.64.12.10.
To investigate the differences in peripapillary vessel density (VD) between compressive optic neuropathy (CON) and normal-tension glaucoma (NTG).
We compared patients with chronic CON and NTG, particularly after strictly controlling the mean extent of macular damage by the area of the ganglion cell-inner plexiform layer (GCIPL) loss in optical coherence tomography (OCT). We compared retinal nerve fiber layer (RNFL) and GCIPL thickness from OCT and peripapillary and macular VD from OCT angiography (OCTA) between the CON and NTG groups.
From the initial 184 patients with CON and 443 patients with OAG, we included 41 patients with CON (57 eyes) and 64 patients with NTG (75 eyes) with a comparable extent of macular GCIPL thinning. Under similar mean macular involvement, the peripapillary VD was significantly lower in the CON group than in the NTG group after considering the effects of age, spherical equivalent, visual field sensitivity, peripapillary RNFL (pRNFL) thickness, GCIPL thickness, and image quality scores (P < 0.001). Marked loss of VD in the temporal and nasal sectors in CON was notable, attributing to the significantly lower peripapillary VD compared to NTG.
Patients with CON had a significantly lower peripapillary VD than those with NTG under similar mean degrees of pRNFL thickness and GCIPL damage. Our results reveal the potential utility of OCTA VD besides OCT pRNFL thickness, in relation to different topographic patterns of pRNFL loss, and possible differences in the pathogenesis of microvascular compromise between CON and NTG.
探讨压迫性视神经病变（CON）和正常眼压性青光眼（NTG）之间视乳头周围血管密度（VD）的差异。
我们比较了慢性 CON 和 NTG 患者，特别是通过光学相干断层扫描（OCT）中神经节细胞-内丛状层（GCIPL）丢失面积来严格控制黄斑损伤的平均程度后。我们比较了 OCT 中的视网膜神经纤维层（RNFL）和 GCIPL 厚度以及 OCT 血管造影（OCTA）中的视乳头周围和黄斑 VD。
从最初的 184 例 CON 患者和 443 例 OAG 患者中，我们纳入了 41 例 CON（57 只眼）和 64 例 NTG（75 只眼）患者，他们的黄斑 GCIPL 变薄程度相当。在考虑年龄、等效球镜、视野敏感度、视乳头周围 RNFL（pRNFL）厚度、GCIPL 厚度和图像质量评分的影响后，CON 组的视乳头周围 VD 明显低于 NTG 组（P<0.001）。在 CON 中，颞侧和鼻侧的 VD 明显丧失，这归因于与 NTG 相比，视乳头周围 VD 明显降低。
在相似的平均 pRNFL 厚度和 GCIPL 损伤程度下，CON 患者的视乳头周围 VD 明显低于 NTG 患者。我们的研究结果揭示了 OCTA VD 除了 OCT pRNFL 厚度之外的潜在用途，与不同的 pRNFL 丧失的拓扑模式以及 CON 和 NTG 之间微血管损伤的发病机制可能存在差异有关。
