Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye.
Clinic of Ophthalmology, Karaman Training and Research Hospital, University of Health Sciences, Karaman, Turkiye.
J Glaucoma. 2024 Dec 1;33(12):964-972. doi: 10.1097/IJG.0000000000002483. Epub 2024 Aug 15.
In early pseudoexfoliation glaucoma (PXG), radial peripapillary capillary vessel density (RPC-VD) was reduced nasally, while the retinal nerve fiber layer (RNFL) thinned from the nasal to temporal sectors. Nonglaucomatous fellow eyes demonstrated no RPC-VD or RNFL loss in comparison to the controls.
To evaluate peripapillary and macular vessel density (VD) in unilateral early PXG and unaffected fellow eyes compared with healthy controls.
This cross-sectional study included 28 eyes with PXG and 28 nonglaucomatous, pseudoexfoliation-free fellow eyes of 28 patients, and 28 eyes of 28 healthy participants. All subjects underwent optical coherence tomography angiography (OCTA) imaging. RPC-VD, macular VD, retinal nerve fiber layer (RNFL) thickness, and ganglion cell complex (GCC) thickness were compared among the groups.
The average RPC-VD and RNFL thickness were significantly reduced in PXG eyes compared with both fellow eyes and the control group ( P <0.001-0.002). In fellow eyes, neither RNFL thickness nor RPC-VD parameters differed from controls. In sector-based analysis, RPC-VD loss in the PXG eyes was significant in the nasal-superior, nasal-inferior, superonasal, and inferonasal sectors ( P =0.005-0.031), while RNFL thinning extended from the nasal sectors toward the superotemporal and temporal-superior sectors ( P <0.001-0.014). RPC-VD was strongly correlated with average and all sector RNFL thicknesses ( r =0.402-0.759, P <0.001-0.034). While perifoveal GCC differed from both fellow and control eyes ( P <0.001), there was no significant difference in macular VD parameters among the groups. RPC-VD and RNFL had comparable area under receiver operating curve (AUROC) values in the average and nasal sectors, while RPC-VD had no ability to distinguish PXG from controls in the superotemporal and inferotemporal sectors.
In the early stages of PXG, RNFL parameters mostly appear to have better diagnostic ability than RPC-VD parameters. Fellow eyes in the preclinical stage may not exhibit any RPC-VD and RNFL loss detectable by current OCTA technology.
在早期假性剥脱综合征（PXG）中，视盘旁毛细血管密度（RPC-VD）在鼻侧减少，而视网膜神经纤维层（RNFL）从鼻侧向颞侧变薄。与对照组相比，非青光眼对侧眼没有 RPC-VD 或 RNFL 损失。
评估单侧早期 PXG 及未受影响对侧眼与健康对照者的视盘旁和黄斑血管密度（VD）。
本横断面研究纳入了 28 只 PXG 眼和 28 只无青光眼、无假性剥脱的对侧眼，以及 28 只健康对照者的双眼。所有受试者均行光学相干断层扫描血管造影（OCTA）检查。比较各组间 RPC-VD、黄斑 VD、视网膜神经纤维层（RNFL）厚度和节细胞复合体（GCC）厚度。
与对侧眼和对照组相比，PXG 眼的平均 RPC-VD 和 RNFL 厚度均显著降低（P<0.001-0.002）。对侧眼的 RNFL 厚度和 RPC-VD 参数与对照组无差异。在基于扇形的分析中，PXG 眼的 RPC-VD 损失在鼻上、鼻下、鼻上颞和鼻下颞象限显著（P=0.005-0.031），而 RNFL 变薄从鼻侧延伸至颞上和颞上颞侧（P<0.001-0.014）。RPC-VD 与平均和所有象限的 RNFL 厚度均呈强相关性（r=0.402-0.759，P<0.001-0.034）。虽然中心凹旁 GCC 与对侧眼和对照组均有差异（P<0.001），但各组间黄斑 VD 参数无差异。在平均和鼻侧象限，RPC-VD 和 RNFL 的受试者工作特征曲线（ROC）下面积（AUROC）值相当，而在颞上和颞下象限，RPC-VD 无能力将 PXG 与对照组区分开。
在 PXG 的早期阶段，RNFL 参数的诊断能力似乎优于 RPC-VD 参数。在临床前期，对侧眼可能没有目前的 OCTA 技术可检测到的任何 RPC-VD 和 RNFL 损失。
