Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure.
Optical coherence tomographic angiography study of perfusion recovery after surgical lowering of intraocular pressure.
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DOI：
10.1038/s41598-021-96225-7
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发表时间：
2021-08-26
影响因子：
4.6
通讯作者：
Huang D
中科院分区：
文献类型：
--
作者：
Liu L;Takusagawa HL;Greenwald MF;Wang J;Alonzo B;Edmunds B;Morrison JC;Tan O;Jia Y;Huang D
我们使用光学相干断层扫描血管造影（OCTA）研究了青光眼手术降低眼内压（IOP）后视网膜灌注恢复的时间和位置。对 17 名患者进行了分析。术前和术后 6 周、3 个月和 6 个月进行以椎间盘为中心的 4.5 × 4.5 mm OCTA 扫描。对视乳头周围视网膜神经纤维层 (NFL) 厚度、NFL 丛毛细血管密度 (NFLP-CD) 和视野 (VF) 进行整体测量和 8 个相应区域的测量。低灌注面积 (LPA) 用于评估局部 NFLP-CD 显着低于正常值的累积面积。 6 个月时，平均 IOP 下降 5.3 mmHg (P = 0.004)，LPA 下降 15% (P = 0.005)，NFLP-CD 改善 12% (P < 0.001)。 NFL 厚度和 VF 平均偏差在任何时间点都没有显着变化。在术前 NFLP-CD 损失显着的扇区中，术前 NFLP-CD 稀疏程度最小的扇区在 6 个月时的恢复程度最高 (P < 0.001)。总之，手术降低眼压可能会在 6 个月后改善 NFLP 毛细血管灌注。灌注恢复往往发生在基线 NFL 稀疏程度最小的区域。 OCTA 参数可能具有作为青光眼治疗的药效生物标志物的潜在用途。
We investigated the time and location of retinal perfusion recovery after surgical intraocular pressure (IOP) lowering in glaucoma by using optical coherent tomography angiography (OCTA). Seventeen patients were analyzed. The 4.5 × 4.5-mm OCTA scans centered on the disc were performed preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. The peripapillary retinal nerve fiber layer (NFL) thickness, NFL plexus capillary density (NFLP-CD) and visual field (VF) were measured overall and in 8 corresponding sectors. The low-perfusion area (LPA) was used to assess the cumulative area where local NFLP-CD was significantly below normal. At 6 months, the average IOP decreased 5.3 mmHg (P = 0.004), LPA decreased by 15% (P = 0.005), and NFLP-CD improved by 12% (P < 0.001). The NFL thickness and VF mean deviation didn’t change significantly at any time point. Among the sectors with significant preoperative NFLP-CD loss, the recovery at 6 months was greatest in sectors with minimal preoperative NFL thinning (P < 0.001). In conclusion, surgical IOP lowering may improve NFLP capillary perfusion after 6 months. The perfusion recovery tended to occur in areas with minimal NFL thinning at baseline. OCTA parameters may have potential usefulness as pharmacodynamic biomarkers for glaucoma therapy.
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