Shimazaki Takeru, Nitta Eri, Nakano Yuki, Kobayashi Nobuko, Kojima Hirokazu, Hara Ayaka, Suzuma Kiyoshi
Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa prefecture, Japan.
J Glaucoma. 2025 Apr 1;34(4):290-296. doi: 10.1097/IJG.0000000000002527. Epub 2024 Dec 12.
Trabeculectomy increases tissue blood flow superior and temporal in the optic nerve head (ONH). Improvement of tissue blood flow superior and temporal in the optic nerve could be an indicator of the effectiveness of glaucoma treatment.
To investigate changes in tissue blood flow at the ONH before and after trabeculectomy.
This prospective study included 53 eyes who underwent trabeculectomy. The mean blur rate of the tissue area mean blur rate of the tissue area (MT) was determined using laser speckle flowgraphy preoperatively and 1 and 3 months postoperatively. MT, laser speckle flowgraphy waveform parameters [blowout score (BOS) and Resistivity Index (RI)], intraocular pressure (IOP), and ocular perfusion pressure (OPP) were analyzed preoperatively and at 3 months postoperatively.
Postoperatively, IOP decreased (17.9±6.0-9.2±3.4 mm Hg) and OPP increased (43.3±9.2-52.1±6.4 mm Hg). As previously described, BOS increased (73.5±8.3-76.7±6.5; P < 0.001) with an inverse correlation to IOP and in proportion with OPP; RI decreased (0.40±0.1-0.35±0.08; P < 0.001) with an inverse correlation to OPP and in proportion to IOP. However, we found that MT increased significantly after surgery (7.9±2.2-8.8±2.2 AU; P = 0.002) without significant association between MT and IOP or OPP. In the 4 quadrants of the ONH, BOS significantly increased, while RI significantly decreased after surgery in all quadrants. In contrast, MT significantly increased in the superior and temporal quadrants only.
Blood flow increases in the superior and temporal ONH.
小梁切除术可增加视神经乳头（ONH）上方和颞侧的组织血流。视神经上方和颞侧组织血流的改善可能是青光眼治疗效果的一个指标。
研究小梁切除术前后ONH处组织血流的变化。
这项前瞻性研究纳入了53例行小梁切除术的眼睛。术前以及术后1个月和3个月使用激光散斑血流图测定组织区域的平均模糊率（MT）。分析术前和术后3个月时的MT、激光散斑血流图波形参数[吹出分数（BOS）和阻力指数（RI）]、眼压（IOP）和眼灌注压（OPP）。
术后，IOP降低（17.9±6.0 - 9.2±3.4 mmHg），OPP升高（43.3±9.2 - 52.1±6.4 mmHg）。如前所述，BOS升高（73.5±8.3 - 76.7±6.5；P < 0.001），与IOP呈负相关，与OPP成正比；RI降低（0.40±0.1 - 0.35±0.08；P < 0.001），与OPP呈负相关，与IOP成正比。然而，我们发现术后MT显著增加（7.9±2.2 - 8.8±2.2 AU；P = 0.002），且MT与IOP或OPP之间无显著关联。在ONH的4个象限中，术后所有象限的BOS均显著升高，而RI均显著降低。相比之下，MT仅在上方和颞侧象限显著增加。
ONH上方和颞侧的血流增加。
