The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes.
The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes.
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DOI：
10.1167/iovs.17-21598
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发表时间：
2017-06-01
影响因子：
4.4
通讯作者：
Saeedi O
中科院分区：
文献类型：
--
作者：
Zhang X;Cole E;Pillar A;Lane M;Waheed N;Adhi M;Magder L;Quigley H;Saeedi O
脉络膜厚度随着眼压(IOP)的降低而线性增加。我们研究了青光眼手术后脉络膜血管大小的改变与眼压降低之间的关系。对29例(30只眼)患者进行了术前、术后6个月的标准临床评估、增强深度成像光谱域光学相干断层扫描(OCT)和眼轴测量。每幅增强深度成像光谱域OCT图像分别使用三种不同的方法进行分析，以确定脉络膜厚度、脉络膜血管厚度、脉络膜间质厚度、大脉络膜血管层厚度、中等脉络膜血管层厚度和明暗比。以眼压变化最大为自变量，进行二元线性回归分析。因变量包括脉络膜厚度、脉络膜血管厚度和脉络膜间质厚度，其中眼压变化最大。还完成了使用广义估计方程来解释每只眼睛的多次测量的多变量回归分析。眼压每下降1μ，平均脉络膜血管厚度增加1.5μm(P<；0.0001；95%可信区间0.8，2.1)，脉络膜间质厚度每增加1 mm Hg(P<；0.0001；95%CI，0.8，1.8)。眼压变化与脉络膜大血管层的变化在时间上(P=0.13)、鼻侧(P=0.20)或中心凹下(P=0.18)均无显著相关性。眼压与明暗比之间也无相关性(P=0.16)。低眼压时脉络膜厚度的增加与其血管内和血管外间隔的增加大致相同。
Choroidal thickness increases linearly with intraocular pressure (IOP) lowering. We studied the relationship between the change in size of the choroidal vasculature and IOP lowering after glaucoma procedures. Thirty eyes of twenty-nine patients were examined pre- and postoperatively for up to 6 months with standard clinical assessment, enhanced depth imaging spectral-domain optical coherence tomography (OCT), and axial length measurement. Each enhanced depth imaging spectral-domain OCT image was analyzed using three separate methods to determine the choroidal thickness, choroidal vessel thickness, choroidal interstitial thickness, large choroidal vessel layer thickness, medium choroidal vessel layer thickness, and light-dark ratio. Bivariate linear regression analysis was completed with largest change in IOP as the independent variable. The dependent variables included choroidal thickness, choroidal vessel thickness, and choroidal interstitial thickness, at the largest change in IOP. Multivariable regression analysis using a generalized estimating equation to account for multiple measurements per eye was also completed. Mean choroidal vessel thickness increases 1.5 μm for every 1 mm Hg decrease in IOP (P < 0.0001; 95% confidence interval [CI], 0.8, 2.1) and choroidal interstitial thickness increases 1.3 μm for every 1 mm Hg change in IOP (P < 0.0001; 95% CI, 0.8, 1.8). There was no significant association between change in IOP and change in large choroidal vessel layer temporally (P = 0.13), nasally (P = 0.20), or subfoveally (P = 0.18). There was also no association between IOP and the light-dark ratio (P = 0.16). The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.