Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
, Cairo, Egypt.
Lasers Med Sci. 2023 Oct 28;38(1):246. doi: 10.1007/s10103-023-03907-x.
To compare the microvasculature of the optic disc in open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) after trabeculectomy. This study included 34 patients divided into two groups based on the angle: (1) the OAG Group, which included 24 eyes from 24 patients, and (2) the ACG Group, which included ten eyes from 10 patients. All patients were subjected to comprehensive ophthalmic examinations. It included best-corrected visual acuity (BCVA), Goldmann applanation tonometry, gonioscopy, slit-lamp biomicroscopy, dilated fundus examination, and stereoscopic examination of the optic disc. The central corneal thickness was measured using a Nidek AL scan optical biometer. The visual field was evaluated by standard automated perimetry using Humphrey Field Analyzer (24-2 Swedish interactive threshold algorithm; Carl-Zeiss Meditec, Dublin, CA). Moreover, optical coherence tomography angiography (OCT-A) was performed utilizing the RTVue XR Avanti scanner (Optovue Inc., Fremont, CA, USA) preoperatively as well as 1 month after surgery. There was a statistically significant increase in optic disc vessel density (VD) in the whole image, radial peripapillary, inferior, superior, temporal, and nasal quadrant in OAG after surgery. Regarding the change in VD after surgery in ACG patients, there was a statistically significant increase in optic disc VD in the whole image, radial peripapillary, inferior, superior, temporal, and nasal quadrant in ACG after surgery.Regarding the percentage of VD change following trabeculectomy surgery, there were highly significant differences between the two groups for the whole image, radial peripapillary, inferior quadrant, and temporal quadrant VD. Statistically significant changes were also observed in the superior and nasal quadrants of VD. However, no significant change in VD was detected within the disc. In conclusion, the optic disc VD improved after the reduction of intraocular pressure (IOP) by surgery in both OAG and ACG. However, ACG demonstrated a significant improvement than the OAG.
比较开角型青光眼（OAG）和闭角型青光眼（ACG）患者行小梁切除术前后的视盘微血管。本研究纳入了 34 名患者，根据房角将患者分为两组：（1）OAG 组，包括 24 名患者的 24 只眼；（2）ACG 组，包括 10 名患者的 10 只眼。所有患者均行全面的眼科检查，包括最佳矫正视力（BCVA）、压平眼压测量、房角镜检查、裂隙灯显微镜检查、眼底散瞳检查和视神经盘立体检查。使用尼德克 AL 扫描光学生物测量仪测量中央角膜厚度。使用 Humphrey Field Analyzer（24-2 瑞典交互阈值算法；卡尔蔡司医疗技术公司，都柏林，CA）评估视野。此外，术前和术后 1 个月利用 RTVue XR Avanti 扫描仪（Optovue Inc.，弗里蒙特，CA，美国）行光学相干断层扫描血管造影（OCT-A）检查。OAG 术后，全图像、视盘旁放射状、下方、上方、颞侧和鼻侧象限的视盘血管密度（VD）均有统计学显著增加。ACG 患者术后 VD 变化方面，全图像、视盘旁放射状、下方、上方、颞侧和鼻侧象限的视盘 VD 均有统计学显著增加。关于小梁切除术后 VD 百分比的变化，两组全图像、视盘旁放射状、下方象限和颞侧象限 VD 差异有统计学高度显著性。VD 的上象限和鼻象限也观察到统计学显著变化。然而，视盘内 VD 无明显变化。总之，OAG 和 ACG 患者行手术降低眼压后，视盘 VD 均有改善，但 ACG 的改善程度显著优于 OAG。
