School of Clinical Medicine, Weifang Medical University, Weifang, 261053, China.
Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan, 250021, China.
Graefes Arch Clin Exp Ophthalmol. 2024 Sep;262(9):2961-2970. doi: 10.1007/s00417-024-06464-3. Epub 2024 Apr 8.
This study is to evaluate the correlation between retrobulbar perfusion deficits and glaucomatous visual field defects.
Eighty-four patients with glaucoma and 17 normal subjects serving as controls were selected. Color Doppler imaging (CDI) was used to measure the changes in blood flow parameters in the retrobulbar ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs). Visual field testing was performed using a Humphrey perimeter, categorizing the visual field deficits into four stages according to the Advanced Glaucoma Intervention Study (AGIS) scoring method. Subsequently, the correlation of retrobulbar hemodynamic parameter alterations among glaucomatous patients with varying visual field defects was examined.
The higher the visual field stage, the lower the peak systolic velocity (PSV) of the OA, CRA, and SPCAs in glaucomatous patients. The CRA had the highest sensitivity to changes in its PSV. The PSV of the temporal SPCA (TSPCA-PSV) was lower in advanced glaucoma than in early-stage glaucoma. The PSVs of the OA, CRA, and TSPCA, as well as the resistance index of the CRA (CRA-RI), were positively correlated with the visual field index and the mean deviation. Except for that of OA, the PSV of the retrobulbar vessels was negatively correlated with the pattern standard deviation (PSD). The OA-PSV and end-diastolic velocity (EDV) of the CRA and TSPCA were lower in patients with superior visual field defects than in those with inferior visual field defects.
Greater severity of visual field defects corresponded to poorer retrobulbar blood flow in glaucomatous patients. Patients suffered significant perfusion impairments in the CRA at the early stage, accompanied by SPCA perfusion disorder at the advanced stage. The presence of a bow-shaped defect in the superior or inferior region of the visual field in moderate-stage glaucoma was closely correlated with retrobulbar vascular EDV.
ChiCTR2200059048 (2022-04-23).
本研究旨在评估球后灌注不足与青光眼视野缺损之间的相关性。
选取 84 例青光眼患者和 17 例正常对照者。采用彩色多普勒成像（CDI）测量球后眼动脉（OA）、视网膜中央动脉（CRA）和睫状后短动脉（SPCA）的血流参数变化。采用 Humphrey 视野计进行视野检查，根据高级青光眼干预研究（AGIS）评分方法将视野缺损分为四期。随后，检查了不同视野缺损的青光眼患者球后血流动力学参数改变的相关性。
视野分期越高，青光眼患者 OA、CRA 和 SPCA 的收缩期峰值流速（PSV）越低。CRA 的 PSV 变化最敏感。晚期青光眼的颞侧 SPCA（TSPCA-PSV）PSV 较低。OA、CRA 和 TSPCA 的 PSV 以及 CRA 的阻力指数（CRA-RI）与视野指数和平均偏差呈正相关。除了 OA 之外，球后血管的 PSV 与模式标准差（PSD）呈负相关。视野缺损在上部的患者，OA 的 PSV 和 CRA 的舒张末期速度（EDV）以及 TSPCA 均较低。
青光眼患者视野缺损越严重，球后血流越差。患者在早期 CRA 出现明显的灌注损伤，晚期则出现 SPCA 灌注障碍。中晚期青光眼上方或下方视野出现弓形缺损与球后血管 EDV 密切相关。
ChiCTR2200059048（2022-04-23）。
