Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Invest Ophthalmol Vis Sci. 2024 Jul 1;65(8):47. doi: 10.1167/iovs.65.8.47.
To determine the microstructure of the lamina cribrosa (LC) associated with microvasculature dropout (MvD) of the deep optic nerve head (ONH) in primary open-angle glaucoma (POAG) and to identify factors related to the presence of MvD.
POAG eyes that exhibited MvD in the LC (MvD-LC) or MvD in the peripapillary choroid (MvD-PC) underwent optical coherence tomography and optical coherence tomography angiography (OCTA) to evaluate the structure and microvasculature of the deep ONH, respectively. The presence of MvD-LC or MvD-PC was determined using en face OCTA images of the deep ONH. The sectoral LC thickness (LCT) and LC curvature index (LCCI) (at MvD-LC site, when applicable), the mean LCT and LCCI of the global ONH, and other clinical characteristics were measured and compared between eyes with and without MvD-LC.
The study included 93 eyes with and 51 without MvD-LC. The presence of MvD-LC was associated with lower sectoral LCT (odds ratio [OR] = 0.96, P < 0.001) and mean LCT (OR = 0.97, P = 0.032), larger visual field pattern standard deviation (PSD; OR = 1.20, P = 0.038), and higher pretreatment intraocular pressure (IOP; OR = 1.22, P = 0.012). Fifteen percent of the eyes with MvD-LC (14/93) did not present MvD-PC. Those eyes had younger age (P = 0.043), thicker juxtapapillary choroid (P = 0.018), larger sectoral LCCI (P = 0.040), thicker retinal nerve fiber layer (P = 0.024), smaller PSD (P = 0.008), and higher pretreatment IOP (P = 0.006) than those with both MvD-LC and MvD-PC.
MvD-LC was associated with a localized morphologic alteration of the LC, and eyes with MvD-LC tended to have a higher pretreatment IOP. The clinical implications of MvD-LC should differ from those of MvD-PC in eyes with POAG.
确定与原发性开角型青光眼（POAG）中深层视神经头（ONH）微血管缺失（MvD）相关的筛板（LC）的微观结构，并确定与 MvD 存在相关的因素。
在表现出 LC 中 MvD（MvD-LC）或脉络膜中 MvD（MvD-PC）的 POAG 眼中，分别进行光学相干断层扫描和光学相干断层扫描血管造影（OCTA）以评估深层 ONH 的结构和微血管。使用深层 ONH 的 en face OCTA 图像确定 MvD-LC 或 MvD-PC 的存在。测量并比较了有和无 MvD-LC 的眼睛之间的节段性 LC 厚度（LCT）和 LC 曲率指数（LCCI）（在适用时，在 MvD-LC 部位）、全局 ONH 的平均 LCT 和 LCCI 以及其他临床特征。
该研究包括 93 只眼有 MvD-LC 和 51 只眼无 MvD-LC。存在 MvD-LC 与较低的节段性 LCT（比值比[OR] = 0.96，P < 0.001）和平均 LCT（OR = 0.97，P = 0.032）、较大的视野模式标准偏差（PSD；OR = 1.20，P = 0.038）和较高的预处理眼内压（IOP；OR = 1.22，P = 0.012）相关。有 MvD-LC 的眼睛中有 15％（14/93）没有出现 MvD-PC。这些眼睛的年龄较小（P = 0.043），视神经旁脉络膜较厚（P = 0.018），节段性 LCCI 较大（P = 0.040），视网膜神经纤维层较厚（P = 0.024），PSD 较小（P = 0.008），预处理 IOP 较高（P = 0.006）。
MvD-LC 与 LC 的局部形态改变有关，并且有 MvD-LC 的眼睛往往具有较高的预处理 IOP。POAG 眼中 MvD-LC 的临床意义应与 MvD-PC 不同。
