伴有中心视野损害的开角型青光眼眼进行性黄斑血管密度丧失和视野恶化

IF 2.8 Q1 OPHTHALMOLOGY Ophthalmology. Glaucoma Pub Date : 2024-01-01 DOI:10.1016/j.ogla.2023.06.009

Anna Lee MD, Ko Eun Kim MD, PhD, Woo Keun Song MD, Jooyoung Yoon MD, Michael S. Kook MD

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引用次数: 0

摘要

目的探讨不同青光眼分期的中心视野（CVF）受损的开角型青光眼（OAG）患者的黄斑血管密度（mVD）和黄斑神经节细胞-内丛状层厚度（mGCIPLT）的纵向变化与视野（VF）进展（包括中心视野进展）之间的关系。方法在平均 3.5 年的随访期间，使用 OCT 血管造影术和 OCT 测量眼底旁和眼底周围的连续 mVD 和 mGCIPLT。主要结果测量采用线性混合效应模型比较VF进展者和非进展者之间各参数的变化率。结果在早中期，VF进展者的mGCIPLT（-1.02 vs. -0.47 μm/年）、眼窝旁（-1.12 vs. -0.40%/年）和眼窝周围mVDs（-0.83 vs. -0.44%/年）的变化率明显快于非进展者（所有P均为0.05）。在晚期病例中，只有mVDs的变化率（视网膜旁：-1.47 vs. -0.44%/年）高于非晚期病例（所有P均为0.05）：-0.44%/year; perifoveal：-0.27%/年；均为 P <0.05）有显著差异。通过多变量逻辑回归分析，无论青光眼分期如何，mVD丧失速度越快，VF进展越快；而只有在早中期病例中，mGCIPLT丧失速度与VF进展显著相关。结论无论青光眼分期如何，在有CVF损失的OAG眼中，进行性mVD损失与VF进展（包括中心性VF进展）显著相关。

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Progressive Macular Vessel Density Loss and Visual Field Progression in Open-angle Glaucoma Eyes with Central Visual Field Damage

Purpose

To investigate the association between the longitudinal changes in both macular vessel density (mVD) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and visual field (VF) progression (including central VF progression) in open-angle glaucoma (OAG) patients with central visual field (CVF) damage at different glaucoma stages.

Design

Retrospective longitudinal study.

Participants

This study enrolled 223 OAG eyes with CVF loss at baseline classified as early-to-moderate (133 eyes) or advanced (90 eyes) stage based on the VF mean deviation (MD) (−10 dB).

Methods

Serial mVDs at parafoveal and perifoveal sectors and mGCIPLT measurements were obtained using OCT angiography and OCT during a mean follow-up of 3.5 years. Visual field progression was determined using both the event- and trend-based analyses during follow-up.

Main Outcome Measures

Linear mixed-effects models were used to compare the rates of change in each parameter between VF progressors and nonprogressors. Logistic regression analyses were performed to determine the risk factors for VF progression.

Results

In early-to-moderate stage, progressors showed significantly faster rates of change in the mGCIPLT (−1.02 vs. −0.47 $μ$ m/year), parafoveal (−1.12 vs. −0.40%/year), and perifoveal mVDs (−0.83 vs. −0.44%/year) than nonprogressors (all P < 0.05). In advanced stage cases, only the rates of change in mVDs (parafoveal: −1.47 vs. −0.44%/year; perifoveal: −1.04 vs. −0.27%/year; all P < 0.05) showed significant differences between the groups. By multivariable logistic regression analyses, the faster rate of mVD loss was a predictor of VF progression regardless of glaucoma stage, while the rate of mGCIPLT loss was significantly associated with VF progression only in early-to-moderate stage cases.

Conclusions

Progressive mVD loss is significantly associated with VF progression (including central VF progression) in the OAG eyes with CVF loss regardless of the glaucoma stage.