Chen Qin, Meng Qingwei, Tao Yijin, Liu Jing, Zeng Zhu, Sheng Ye, Yang Wenyan, Cun Qing, Lin Xiaojun, Chen Xi, Huang Guangkun, Zhong Hua
Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Front Med (Lausanne). 2025 Jun 16;12:1620968. doi: 10.3389/fmed.2025.1620968. eCollection 2025.
To investigate changes in peripapillary vessel density (pVD) and retinal nerve fiber layer thickness (pRNFL) in highly myopic glaucoma patients compared to non-highly myopic glaucoma patients and healthy controls, and to evaluate their diagnostic capabilities using optical coherence tomography angiography (OCTA), and to explore the relationship between these biomarkers and visual function.
A total of 382 eyes were recruited, including 101 highly myopic glaucoma eyes, 101 highly myopic control eyes, 90 non - highly myopic glaucoma eyes, and 90 non - highly myopic control eyes. Propensity score matching (PSM) was applied to balance age and axial length between groups. All subjects received comprehensive ophthalmic examinations. OCTA was used to measure pVD, spectral - domain OCT (SD - OCT) for pRNFL, and Humphrey 30-2 SITA standard visual field (VF) testing was performed. pVD and pRNFL were measured across eight peripapillary sectors. Pearson correlation and linear regression analyses were used to assess the relationships between pVD, pRNFL, and visual field mean sensitivity (VFMS). Receiver operating characteristic (ROC) curve analyses were carried out to evaluate the diagnostic performance.
Both highly myopic glaucoma and non-highly myopic glaucoma groups exhibited significantly lower pVD, pRNFL, and VFMS compared to their respective controls ( < 0.001). In highly myopic glaucoma, average pVD was 37.66% versus 46.40% in controls ( < 0.001), and pRNFL was 71.13 μm versus 101.22 μm in controls ( < 0.001). pVD showed stronger correlations with VFMS than pRNFL in both glaucoma groups (highly myopic: = 0.681 vs. = 0.504; non-highly myopic: = 0.749 vs. = 0.722; < 0.001). ROC analysis demonstrated that the pRNFL and pVD have comparable diagnostic abilities in the early-stage of glaucoma ( > 0.05). However, the pRNFL outperforms the pVD in average diagnostic ability ( 0.05). Combining superior-temporal (ST) and inferior-temporal (IT) regions achieved the highest diagnostic accuracy (AUC: 0.905 and 0.965; AUC: 0.934 and 0.942) for both glaucoma groups.
pVD and pRNFL are valuable diagnostic biomarkers for myopic glaucoma. pVD demonstrated a stronger correlation with visual function, making it a promising tool for early glaucoma diagnosis and monitoring in highly myopic patients. Integrating pVD with pRNFL enhances diagnostic precision, particularly in highly myopic patients.
研究高度近视性青光眼患者与非高度近视性青光眼患者及健康对照者相比，视乳头周围血管密度（pVD）和视网膜神经纤维层厚度（pRNFL）的变化，使用光学相干断层扫描血管造影（OCTA）评估其诊断能力，并探讨这些生物标志物与视觉功能之间的关系。
共纳入382只眼，包括101只高度近视性青光眼眼、101只高度近视对照眼、90只非高度近视性青光眼眼和90只非高度近视对照眼。采用倾向得分匹配（PSM）来平衡各组之间的年龄和眼轴长度。所有受试者均接受全面的眼科检查。使用OCTA测量pVD，使用光谱域光学相干断层扫描（SD - OCT）测量pRNFL，并进行Humphrey 30-2 SITA标准视野（VF）测试。在视乳头周围的八个扇形区域测量pVD和pRNFL。采用Pearson相关性分析和线性回归分析来评估pVD、pRNFL与视野平均敏感度（VFMS）之间的关系。进行受试者操作特征（ROC）曲线分析以评估诊断性能。
与各自的对照组相比，高度近视性青光眼组和非高度近视性青光眼组的pVD、pRNFL和VFMS均显著降低（P < 0.001）。在高度近视性青光眼中，平均pVD为37.66%，而对照组为46.40%（P < 0.001），pRNFL为71.13μm，而对照组为101.22μm（P < 0.001）。在两个青光眼组中，pVD与VFMS的相关性均强于pRNFL（高度近视：r = 0.681对r = 0.504；非高度近视：r = 0.749对r = 0.722；P < 0.001）。ROC分析表明，在青光眼早期，pRNFL和pVD具有相当的诊断能力（P > 0.05）。然而，pRNFL在平均诊断能力方面优于pVD（P < 0.05）。对于两个青光眼组，将颞上（ST）和颞下（IT）区域相结合可实现最高的诊断准确性（AUC：0.905和0.965；AUC：0.934和0.942）。
pVD和pRNFL是近视性青光眼的有价值的诊断生物标志物。pVD与视觉功能的相关性更强，使其成为高度近视患者青光眼早期诊断和监测的有前景的工具。将pVD与pRNFL相结合可提高诊断精度，尤其是在高度近视患者中。
