Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Ophthalmic Res. 2024;67(1):257-265. doi: 10.1159/000538407. Epub 2024 Mar 20.
Microcirculation of optic nerve head (ONH) in open-angle glaucoma (OAG) patients with unilateral visual field (VF) loss has yet to be fully investigated, especially the perimetrically unaffected fellow eyes.
Thirty-eight OAG patients with VF defect in one eye and normal VF in the other eye, and thirty-one healthy participants were analyzed. All participants underwent laser speckle flowgraphy (LSFG), spectral-domain optical coherence tomography (SD-OCT) imaging, and VF test for further analyses. LSFG measurements included mean blur rate in all area of ONH (MA), big vessel area of ONH (MV), and tissue area of ONH (MT). SD-OCT parameters included circumpapillary retinal nerve fiber layer (cpRNFL) thickness and macula thicknesses. The difference of LSFG and SD-OCT indices between glaucoma patients and healthy controls were compared. The diagnostic accuracy was analyzed with the areas under the receiver operating characteristic curves (AROCs).
Global cpRNFL thickness and macular thickness in unaffected eyes of OAG patients were higher than their fellow eyes and lower than healthy eyes. MA and MV in healthy eyes and unaffected eyes were significantly higher than in affected eyes. MT in unaffected eyes of OAG patients was higher than in their fellow affected eyes but lower than in healthy eyes. The AROCs were highest for cpRNFL (0.925), followed by macular thickness (0.838), and MT (0.834).
ONH microcirculation in perimetrically unaffected fellow eyes was decreased in OAG patients with unilateral VF loss. LSFG can detect changes of ONH in high-risk eyes before detectable VF damage, which may reflect the vascular pathophysiology for glaucoma.
尚未充分研究开角型青光眼（OAG）患者单侧视野（VF）丧失的视神经头（ONH）微循环，尤其是周边视野正常的对侧眼。
分析 38 例一眼 VF 缺损而另一眼 VF 正常的 OAG 患者和 31 例健康对照者。所有参与者均接受激光散斑血流图（LSFG）、谱域光学相干断层扫描（SD-OCT）成像和 VF 检查进行进一步分析。LSFG 测量包括整个 ONH 平均模糊率（MA）、ONH 大血管面积（MV）和 ONH 组织面积（MT）。SD-OCT 参数包括节段性视网膜神经纤维层（cpRNFL）厚度和黄斑厚度。比较青光眼患者和健康对照组 LSFG 和 SD-OCT 指数的差异。用受试者工作特征曲线下面积（AROCs）分析诊断准确性。
OAG 患者未受影响眼的全局 cpRNFL 厚度和黄斑厚度高于对侧眼，低于健康眼。健康眼和未受影响眼的 MA 和 MV 明显高于受影响眼。OAG 患者未受影响眼的 MT 高于受影响眼，但低于健康眼。cpRNFL 的 AROCs 最高（0.925），其次是黄斑厚度（0.838）和 MT（0.834）。
单侧 VF 丧失的 OAG 患者周边视野未受影响眼的 ONH 微循环减少。LSFG 可在可检测的 VF 损伤之前检测到高危眼的 ONH 变化，这可能反映了青光眼的血管病理生理学。
