OCTA评估高度近视合并原发性开角型青光眼血管密度与视野缺损的相关性

doi:10.3760/cma.j.cn115909-20200527-00227

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Abstract Objective: To evaluate the vessel density and optic disc morphological characteristics in high myopic (HM) patients with primary open-angle glaucoma (POAG), and to investigate the association between vessel density and visual field loss. Methods: This was a cross-sectional study. A total of 24 HM patients (44 eyes) with POAG and 37 HM patients (50 eyes) without POAG (control group) were enrolled in this study. The glaucoma patients were additionally classified into a mild POAG group (13 patients, 20 eyes) and moderate and severe POAG group (15 patients, 24 eyes) according to the visual field mean deviation (MD). All patients underwent imaging using optical coherence tomography angiography (OCTA) to measure vessel density and structural parameters of the optic disc and macula, fudus photography to calculate the optic disc ovality index, and standard automated perimetry. The differences in vessel density, structural parameters and visual field variables between the groups were compared by one-way analysis and the correlation between MD and the optic disc ovality index was performed by Pearson correlation or Spearman correlation analysis. Results: Compared with the control group, the HM patients with POAG showed reduced peripapillary capillary density, deep foveal vessel density and superficial parafoveal vessel density (F=86.340, 18.620, 42.757, all P<0.001), which aggravated the progression of glaucoma. There was no significant difference in the optic disc ovality index between the mild POAG group and control group (P=0.077), while the moderate and severe POAG group showed a decreased optic disc ovality compared to the control group and mild POAG group, and the difference was significant (P<0.001, P=0.028 respectively). The parameter with the highest correlation coefficient to visual field MD was average retinal nerve fiber layer (RNFL) thickness (r=0.782, P<0.001), followed by average ganglion cell complex (GCC) thickness (r=0.621, P<0.001), superficial parafoveal vessel density (r=0.621, P<0.001), peripapillary capillary density (r=0.599, P<0.001) and deep parafoveal vessel density (r=0.420, P=0.002). The disc ovality index was positively associated with the peripapillary capillary density (r=0.318, P=0.002), disc area (r=0.405, P<0.001), average RNFL thickness (r=0.476, P<0.001) and average GCC thickness (r=0.375, P<0.001). Conclusions: In contrast to average RNFL thickness and GCC thickness, decreased vessel density in HM patients with POAG is associated less with visual field loss. The disc ovality index is correlated with a decrease in vessel density and structural damage. The OCTA can be used for early diagnosis of HM with POAG.

Key words： high myopia glaucoma vessel density visual field optical coherence tomography angiography

Received: 27 May 2020

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Fund: National Natural Science Foundation of China (81670859, 81970801); Natural Science Foundation of Hunan Province (2019JJ40001); Science and Technology Foundation of Changsha (kh1801229); Science and Technology Foundation of Aier Eye Hospital Group (AR1906D1, AM1906D2)

Corresponding Authors: Xuanchu Duan, Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, China; Aier School of Ophthalmology, Central South University, Changsha 410015, China; Changsha Aier Eye Hospital, Changsha 410015, China (Email: duanxchu@csu.edu.cn)Xuanchu Duan, Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, China; Aier School of Ophthalmology, Central South University, Changsha 410015, China; Changsha Aier Eye Hospital, Changsha 410015, China (Email: duanxchu@csu.edu.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200527-00227 OR https://www.cjoovs.com/EN/Y2020/V22/I12/881

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