Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma.
Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma.
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DOI：
10.1016/j.ophtha.2016.08.041
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发表时间：
2016-12
期刊：
影响因子：
13.7
通讯作者：
Weinreb RN
中科院分区：
文献类型：
--
作者：
Yarmohammadi A;Zangwill LM;Diniz-Filho A;Suh MH;Yousefi S;Saunders LJ;Belghith A;Manalastas PI;Medeiros FA;Weinreb RN
评价光学相干断层扫描血管造影术（OCT-A）测量血管密度与原发性开角型青光眼（POAG）视野缺损严重程度之间的相关性。观察性横断面研究31例健康人、48例青光眼疑似患者和74例青光眼参与者的153只眼睛参加青光眼诊断创新研究。所有眼睛均接受OCT-A成像（Angiovue，Optovue; Fremont，CA）和谱域OCT（Avanti，Optovue; Fremont，CA），沿着标准自动视野检查（SAP）。视网膜血管信息总结为血管密度，即选定区域中流动血管所占面积的百分比。利用视网膜神经纤维层（RNFL）的两个测量值：视乳头周围血管密度（cpVD）（视盘周围750 μ m宽的椭圆环）;全图像血管密度（wiVD）（整个4.5 × 4.5 mm扫描视野）视野丧失严重程度（报告为SAP平均偏差（MD））与OCT-A血管密度之间的相关性与POAG眼相比，正常眼RNFL内微血管网较密集。wiVD和cpVD的血管密度分别为55.5，51.3，48.3，41.7%和62.8，61.0，57.5，49.6%（P<0.001）。视野损害程度与cpVD和wiVD的相关性（R2分别为0.54和0.51）强于视野损害与RNFL（R2=0.36）和边缘面积（R2=0.19）的相关性（均P<0.05）。校正混杂因素后的多变量回归分析显示，cpVD每降低1%与MD损失0.64 dB相关，wiVD每降低1%与MD损失0.66 dB相关。此外，即使在控制了结构损失的影响后，血管密度和视野损伤的严重程度之间的关联也被发现是显著的。血管密度降低与视野损伤的严重程度显著相关，而与结构损失无关。OCT-A是一种有前途的青光眼治疗技术，可能增强对血管在疾病病理生理学中作用的理解
To evaluate the association between vessel density measurements using optical coherence tomography angiography (OCT-A) and severity of visual field loss in primary open-angle glaucoma (POAG) Observational cross-sectional study One hundred and fifty three eyes from 31 healthy, 48 glaucoma suspects, and 74 glaucoma participants enrolled in the Diagnostic Innovations in Glaucoma Study All eyes underwent imaging using an OCT-A (Angiovue, Optovue; Fremont, CA) and a spectral domain OCT (Avanti, Optovue; Fremont, CA), along with standard automated perimetry (SAP). Retinal vasculature information was summarized as vessel density, the percent of area occupied by flowing blood vessels in the selected region. Two measurements from the retinal nerve fiber layer (RNFL) were utilized: circumpapillary vessel density (cpVD) (750-μm-wide elliptical annulus around the optic disc); and whole image vessel density (wiVD) (entire 4.5 × 4.5 mm scan field) Associations between severity of visual field loss, reported as SAP mean deviation (MD) and OCT-A vessel density Compared to POAG eyes, normal eyes demonstrated a denser microvascular network within the RNFL. Vessel density was higher in normal eyes followed by glaucoma suspects, mild glaucoma and moderate to severe glaucoma eyes for wiVD (55.5, 51.3, 48.3, 41.7% respectively) and for cpVD (62.8, 61.0, 57.5, 49.6% respectively) (P<0.001 for both). The association between the severity of visual field damage (MD) with cpVD and wiVD was stronger (R2=0.54, and R2=0.51 respectively) than the association between visual field MD and RNFL (R2=0.36) and rim area (R2=0.19) (P<0.05 for all). Multivariate regression analysis, adjusted for confounders, showed that each 1% decrease in cpVD was associated with 0.64 dB loss in MD and each 1% decrease in wiVD, was associated with 0.66 dB loss in MD. In addition, the association between vessel density and the severity of visual field damage was found to be significant even after controlling for the effect of structural loss Decreased vessel density was significantly associated with severity of visual field damage independent of the structural loss. OCT-A is a promising technology in glaucoma management, potentially enhancing the understanding of vascular role in the pathophysiology of the disease