Characterization of Prelaminar Wedge-Shaped Defects in Primary Open-Angle Glaucoma.
Characterization of Prelaminar Wedge-Shaped Defects in Primary Open-Angle Glaucoma.
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原发性开角型青光眼椎板前楔形缺损的特征分析。
DOI：
10.1080/02713683.2020.1836229
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发表时间：
2021-06
影响因子：
2
通讯作者：
Shen LQ
中科院分区：
文献类型：
--
作者：
Chiou CA;Wang M;Taniguchi EV;Nascimento E Silva R;Khoroshilov A;Li D;Wang H;Greenstein SH;Brauner SC;Turalba AV;Pasquale LR;Shen LQ
目的探讨扫描源光学相干断层扫描(SS-OCT)检测原发性开角型青光眼(POAG)板层前楔形缺损区(PLWD)的临床意义。在这项回顾性病例对照研究中，PLWD被定义为在横断面SS-OCT扫描上出现在视神经前板组织表面的三角形缺陷，而不是邻近血管。两名蒙面诊断的观察员独立审查了检测PLWD和筛板缺陷的扫描结果。影像前2年内发生的椎间盘出血病史是从图表中获得的。每名受试者随机选择一只眼睛。采用双侧t检验、Bonferroni校正的方差分析和多变量Logistic回归分析来探讨与PLWD相关的人口统计学和临床特征。POAG组40只眼，对照组23只眼。POAG组(n=11)和对照组(n=1，p=0.04)的PLWDS发生率分别为27.5%和4.3%。重复SS-OCT成像的眼睛(7只POAG和0只对照)有持续性的PLWD。伴有PLWD的POAG眼有椎间盘出血病史(45.5%)多于无PLWD的POAG眼(3.4%，P=0.004)。在多变量分析中，在调整了年龄、性别、视野平均偏差和最大眼压后，有PLWD的POAG与无PLWD的POAG相比，观察到的椎间盘出血的几率增加(OR=21.695%CI，2.2~589.0，P=0.02)。伴有PLWD的POAG患者筛板缺损率(45.5%)明显高于无PLWD的POAG患者(3.4%，p=0.01)，但与对照组(8.7%，p=0.07)差异无统计学意义。与所有没有PLWD的患者相比，在调整了年龄、性别和最大眼压后，PLWD患者发生筛板缺陷的几率增加(OR=44.895%可信区间6.3-703.6，p<；0.001)。PLWD在POAG中比对照眼更常见，并与椎间盘出血和筛板缺损史相关。PLWDS可能是青光眼损害的一个有用的成像生物标志物。
To determine the clinical relevance of prelaminar wedge defects (PLWDs) detected by swept-source optical coherence tomography (SS-OCT) in primary open angle glaucoma (POAG). In this retrospective case-control study, PLWDs were defined as triangular-shaped defects at the surface of the optic nerve prelaminar tissue, not adjacent to blood vessels, present on cross-sectional SS-OCT scans. Two observers masked to diagnosis independently reviewed scans to detect PLWDs and lamina cribrosa defects. History of disc hemorrhage, occurring within 2 years prior to imaging, was obtained from chart review. One eye per subject was randomly selected. Two-sided t-tests, analysis of variance with Bonferroni correction, and multivariable logistic regression analysis were performed to explore demographic and clinical features associated with PLWDs. 40 POAG and 23 control eyes were included. PLWDS were found in 27.5% of POAG (n=11) and 4.3% of controls (n=1, p=0.04). Eyes with repeat SS-OCT imaging (7 POAG and 0 controls) had persistent PLWDs. More POAG eyes with PLWDs had a history of disc hemorrhage (45.5%) than POAG eyes without PLWDs (3.4%, p=0.004). On multivariable analysis, compared to POAG without PLWDs, POAG with PLWDs had increased odds of observed disc hemorrhage (OR=21.6, 95% CI, 2.2–589.0, p=0.02) after adjusting for age, gender, visual field mean deviation and maximum intraocular pressure (IOP). POAG with PLWDs had more lamina cribrosa defects (45.5%) than POAG without PLWDs (3.4%, p=0.01) but did not differ significantly from controls (8.7%, p=0.07). Compared to all patients without PLWDs, patients with PLWDs had increased odds of having lamina cribrosa defects (OR=44.8; 95% CI, 6.3–703.6, p<0.001) after adjusting for age, gender, and maximum IOP. PLWDs were more frequently found in POAG than control eyes and were associated with a history of disc hemorrhage and lamina cribrosa defects. PLWDs may be a useful imaging biomarker of glaucomatous damage.
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