脉络膜微血管缺失及其与原发性开角型青光眼和剥脱性青光眼进展的关系。

Choroidal microvascular dropout and its relationship to progression in primary open-angle and pseudoexfoliation glaucoma.

作者信息

Park Jimin, Jo Youn Hye, Sung Kyung Rim

机构信息

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.

Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.

出版信息

BMC Ophthalmol. 2025 Apr 4;25(1):172. doi: 10.1186/s12886-025-03977-1.

DOI:10.1186/s12886-025-03977-1

PMID:40186156

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11969982/

Abstract

BACKGROUND

To compare the longitudinal change of choroidal microvascular dropout (CMvD) and its relationship with glaucoma progression between primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG).

METHODS

The analysis included 114 eyes of 114 patients, with 57 POAG and 57 PXG eyes matched by age and visual field (VF) mean deviation (MD). The angular circumference (AC) of CMvD was measured using the en-face choroidal layer images of optical coherence tomography angiography at baseline and the final follow-up. Progression of CMvD was defined as an increase in AC beyond measurement variability (-3.85° to + 3.28°) or the appearance of new CMvD during follow-up. Glaucoma progression was determined by MD change rate.

RESULTS

The prevalence of CMvD was significantly higher in POAG than in PXG eyes (68.4% vs. 43.9%, p = 0.008) at baseline. However, by the final visit, the difference in prevalence between the groups was not significant (68.4% vs. 56.1%, p = 0.178). During the study period, seven PXG eyes developed new CMvD. There was no significant difference in MD progression rate between the stable and progressed CMvD subgroups in POAG (-0.7 ± 0.8 dB/year vs. - 0.8 ± 0.5 dB/year, p = 0.715). In contrast, PXG eyes showed a significantly faster MD progression rate in the progressed CMvD subgroup than in those with stable CMvD subgroup (-0.4 ± 0.7 dB/year vs. - 1.2 ± 0.8 dB/year, p = 0.010).

CONCLUSIONS

The progression of CMvD was more frequently observed in PXG eyes than POAG eyes and showed association with faster VF progression in PXG eyes.

摘要

背景

比较原发性开角型青光眼（POAG）和剥脱性青光眼（PXG）中脉络膜微血管缺失（CMvD）的纵向变化及其与青光眼进展的关系。

方法

分析纳入114例患者的114只眼，其中57只POAG眼和57只PXG眼，根据年龄和视野（VF）平均偏差（MD）进行匹配。在基线和最终随访时，使用光学相干断层扫描血管造影的脉络膜层正面图像测量CMvD的角周长（AC）。CMvD的进展定义为随访期间AC增加超过测量变异性（-3.85°至+3.28°）或出现新的CMvD。青光眼进展通过MD变化率确定。

结果

基线时，POAG眼中CMvD的患病率显著高于PXG眼（68.4%对43.9%，p = 0.008）。然而，到最后一次就诊时，两组患病率差异无统计学意义（68.4%对56.1%，p = 0.178）。在研究期间，7只PXG眼出现了新的CMvD。POAG中稳定和进展性CMvD亚组的MD进展率差异无统计学意义（-0.7±0.8 dB/年对-0.8±0.5 dB/年，p = 0.715）。相比之下，PXG眼中进展性CMvD亚组的MD进展率显著快于稳定CMvD亚组（-0.4±0.7 dB/年对-1.2±0.8 dB/年，p = 0.010）。