Optical Coherence Tomography Angiography Macular and Peripapillary Vessel Perfusion Density in Healthy Subjects, Glaucoma Suspects, and Glaucoma Patients
Optical Coherence Tomography Angiography Macular and Peripapillary Vessel Perfusion Density in Healthy Subjects, Glaucoma Suspects, and Glaucoma Patients
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DOI：
10.1167/iovs.17-22865
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发表时间：
2017-11-01
影响因子：
4.4
通讯作者：
Bandello, Francesco
中科院分区：
文献类型：
--
作者：
Triolo, Giacinto;Rabiolo, Alessandro;Bandello, Francesco
目的。评估青光眼疑似患者（GS）和青光眼患者的黄斑和视乳头周围血管灌注密度（VD）；将神经节细胞内丛状层 (GCIPL) 和视网膜神经纤维层 (RNFL) 厚度与黄斑和视乳头周围 VD 相关联；并评价结构和血管参数的诊断准确性。方法。从2016年7月1日到2017年1月31日，连续招募了一系列GS、青光眼患者和健康受试者。所有受试者均接受了标准自动视野检查、谱域光学相干断层扫描（OCT）和以中央凹和视神经为中心的6 x 6毫米光学相干断层扫描血管造影（OCT-A）。 结果。纳入了 40 名对照患者、40 名 GS 患者和 40 名青光眼患者。与对照组和 GS 相比，青光眼组的视乳头周围 RNFL、GCIPL 和黄斑 RNFL 厚度显着降低（P < 0.01）。青光眼组视乳头周围的平均VD以及上、下象限的VD均降低（P<0.05）。在乳头周围区域，发现 RNFL 厚度与 VD 之间存在相关性；相反，所有组中 GCIPL 厚度与黄斑 VD 之间均未发现统计学显着相关性（均 P > 0.05）。与视盘周围和黄斑 VD 相比，视盘周围 RNFL 和 GCIPL 显示出更高的诊断能力。结论。视乳头周围和黄斑区域的结构损伤都很明显。血管损伤似乎不太明显，因为仅在青光眼组和放射状视乳头周围神经丛中可见。对于结构变量的诊断能力非常出色，对于视盘周围 VD 的诊断能力较差，但仍然良好，对于黄斑 VD 的诊断能力较差。
PURPOSE. To evaluate macular and peripapillary vessel perfusion density (VD) in glaucoma suspects (GS) and glaucoma patients; to correlate ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thicknesses with macular and peripapillary VD; and to evaluate the diagnostic accuracy of the structural and vascular parameters.METHODS. A consecutive series of GS, glaucoma patients, and healthy subjects was prospectively recruited from July 1, 2016, to January 31, 2017. All subjects underwent standard automated perimetry, spectral-domain optical coherence tomography (OCT), and 6 x 6-mm optical coherence tomography angiography (OCT-A) centered on the fovea and optic nerve.RESULTS. Forty controls, 40 GS, and 40 glaucoma patients were enrolled. Peripapillary RNFL, GCIPL, and macular RNFL thicknesses significantly decreased in the glaucoma group compared to controls and GS (P < 0.01). Peripapillary VD in average and in the superior and inferior quadrants decreased in the glaucoma group (P 0.05). At the peripapllary area, a correlation between RNFL thickness and VD was found; conversely, no statistically significant correlation was found between GCIPL thicknesses and macular VD (all P > 0.05) in all groups. Peripapillary RNFL and GCIPL showed higher diagnostic capacity compared to peripapillary and macular VDs.CONCLUSIONS. Structural damage is evident both in the peripapillary and in macular areas. Vascular damage seems to be less prominent, as it was seen only for the glaucoma group and at the radial peripapllary plexus. Diagnostic abilities are excellent for structural variables, less so but still good for peripapillary VD, and poor for macular VD.