Optical Coherence Tomography Angiography and Visual Field Progression in Primary Angle Closure Glaucoma.
Optical Coherence Tomography Angiography and Visual Field Progression in Primary Angle Closure Glaucoma.
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DOI：
10.1097/ijg.0000000000001745
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发表时间：
2021-03-01
影响因子：
2
通讯作者：
Weinreb RN
中科院分区：
文献类型：
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作者：
Rao HL;Srinivasan T;Pradhan ZS;Sreenivasaiah S;Rao DAS;Puttaiah NK;Devi S;Moghimi S;Mansouri K;Webers CAB;Weinreb RN
评价原发性闭角型青光眼（PACG）的光学相干断层扫描血管造影（OCTA）特征与既往视野（VF）进展之间的相关性。在一项横断面研究中，31例PACG患者的46只眼接受了OCTA成像，随访时间≥3年，进行了5次可靠的VF检查。使用线性混合模型评估了临床（年龄、性别、抗青光眼药物数量、随访期间眼内压的平均值和SD）、OCT（平均视网膜神经纤维层和神经节细胞复合体厚度）和OCTA（椎间盘和黄斑扫描的全表面血管密度、深层微血管脱落[MvD]）参数对平均偏差（MD）变化率的影响。基线VF的平均（±标准差）MD为−7.4 ± 7.3 dB，MD变化率为−0.32±0.29 dB/年。视盘和黄斑区全表面血管密度分别为39.5%±8.1和38.7%±4.4。33.3%的患眼出现MvD。多变量混合模型显示，较低的全表面椎间盘（系数：0.02，p=0.03）和黄斑血管密度（系数：0.04，p=0.02）与MD下降速度更快显著相关。在多变量模型中，与更快进展显著相关的其他因素是年龄较大（系数：-0.02，p<0.05）和存在全身性高血压（系数：-0.37，p=0.01）和糖尿病（系数：-0.28，p=0.05）。使用OCTA测量的较低浅表血管密度与PACG中更快的VF进展显著相关。在这些眼中，OCTA参数可作为提示既往VF进展的生物标志物。OCT血管造影显示，较低的全表面椎间盘（系数：0.02，p=0.03）和黄斑血管密度（系数：0.04，p=0.02）与平均偏差下降速度更快显著相关。
To evaluate the association between optical coherence tomography angiography (OCTA) features and prior visual field (VF) progression in primary angle closure glaucoma (PACG). In a cross-sectional study, 46 eyes of 31 PACG patients with 5 reliable VF examinations performed over ≥3 years of follow-up underwent OCTA imaging. Effect of clinical (age, gender, number of anti-glaucoma medications, mean and SD of intraocular pressure during follow-up), OCT (average retinal nerve fiber layer and ganglion cell complex thickness) and OCTA (whole enface vessel density of disc and macular scan, deep-layer microvascular dropout [MvD]) parameters on the rate of mean deviation (MD) change was evaluated using linear mixed models. Average (± standard deviation) MD of the baseline VF was −7.4 ± 7.3 dB, and rate of MD change was −0.32±0.29 dB/year. Whole enface vessel density of disc and macular scans was 39.5%±8.1 and 38.7%±4.4, respectively. MvD was noted in 33.3% of the eyes. Multivariate mixed models showed that lower whole enface disc (coefficient: 0.02, p=0.03) and macular vessel densities (coefficient: 0.04, p=0.02) were significantly associated with faster rate of MD decline. Other factors significantly associated with faster progression in multivariate models were older age (coefficient: −0.02, p<0.05) and the presence of systemic hypertension (coefficient: −0.37, p=0.01) and diabetes (coefficient: −0.28, p=0.05). Lower superficial vessel density measured using OCTA was significantly associated with faster VF progression in PACG. In these eyes, OCTA parameters can serve as biomarker suggestive of past VF progression. Lower whole enface disc (coefficient: 0.02, p=0.03) and macular vessel densities (coefficient: 0.04, p=0.02) on OCT angiography were significantly associated with faster rate of mean deviation decline.