Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiaotong University, 197 Ruijin Er Road, Shanghai, 200025, China.
Department of Ophthalmology, Renji Hospital Affiliated Medical School, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
Lasers Med Sci. 2024 Jun 11;39(1):154. doi: 10.1007/s10103-024-04108-w.
To investigate the diagnostic ability of retinal superficial vasculature evaluation by optic coherence tomography angiography (OCTA) combined with visual field (VF) testing for early primary open-angle glaucoma (POAG).
In this cross-sectional study, 84 participants were included, including 11 in the ocular hypertension (OHT) group, 11 in the preperimetric POAG (pre-POAG) group, 29 in the early POAG group and 33 in the control group. All participants underwent 6 × 6 mm scans of macula and optic nerved head by optic coherence tomography (OCT) and OCTA, along with white-on-white and blue-on-yellow VF testing by static automated perimetry. The ability of diagnosing early glaucoma by either various examinations separately or combination of examinations in both terms of function and structure was studied using the receiver operating characteristic (ROC) curve and the area under the curve (AUC).
The superficial retinal vessel densities (VD) in peri-nasal, para-temporal, peri-temporal and peri-inferior regions around the macula, as well as vessel area densities (VAD) in all peripapillary regions, were significantly different among the four groups, with lower VD or VAD in the early POAG patients compared to the normal individuals. The diagnostic ability of peripapillary superficial retinal VAD alone or VF testing alone was limited for early POAG only. However, the combination of these two was more effective in distinguishing normal individuals from OHT subjects or pre-POAG patients without VF defects, with better performance than the combination of peripapillary retinal nerve fiber layer (RNFL) thickness and VF indicators.
Peripapillary retinal vessel densities were generally lower in early POAG patients compared to normal individuals. The combination of peripapillary superficial retinal VAD by OCTA with white-on-white VF testing improved the ability to distinguish POAG patients at early stage without function impairment, which may help in providing reference and guidance for the following-up and treatment of suspected POAG patients.
探讨光学相干断层扫描血管造影（OCTA）联合视野（VF）检查对早期原发性开角型青光眼（POAG）的视网膜浅层血管评估的诊断能力。
本横断面研究纳入 84 名参与者，包括 11 名高眼压（OHT）组、11 名亚临床 POAG（pre-POAG）组、29 名早期 POAG 组和 33 名对照组。所有参与者均接受黄斑和视神经头 6×6mm 的光学相干断层扫描（OCT）和 OCTA 扫描，以及静态自动视野计的白对白和蓝黄 VF 测试。通过受试者工作特征（ROC）曲线和曲线下面积（AUC），研究了分别通过各种检查或同时通过结构和功能检查对早期青光眼的诊断能力。
在黄斑周围鼻侧、颞侧、颞下和下周边区的浅层视网膜血管密度（VD），以及所有视盘周围区的血管面积密度（VAD）在 4 组之间差异均有统计学意义，早期 POAG 患者的 VD 或 VAD 明显低于正常个体。单独的视盘周围浅层视网膜 VAD 或 VF 测试的诊断能力仅对早期 POAG 有限。然而，这两种方法的结合在区分正常个体和 OHT 个体或无 VF 缺陷的 pre-POAG 患者方面更有效，其性能优于视盘周围视网膜神经纤维层（RNFL）厚度和 VF 指标的结合。
与正常个体相比，早期 POAG 患者的视盘周围视网膜血管密度普遍较低。OCTA 联合白对白 VF 测试的视盘周围浅层视网膜 VAD 组合可提高在无功能损害的情况下区分早期 POAG 患者的能力，这可能有助于为疑似 POAG 患者的随访和治疗提供参考和指导。
