原发性开角型青光眼视盘周围血管密度变化的研究

Study of peripapillary vessel density in primary open angle glaucoma

目的:比较原发性开角型青光眼患者(POAG)与正常人视盘周围血管密度(VD)的差异,并评价视盘周围VD在POAG中的诊断价值。方法:连续纳入2018-03/12期间在我院初诊的POAG患者60例。同时纳入60例年龄、性别匹配的正常志愿者作为对照。采用光相干断层扫描血流成像(OCTA)技术检测并比较POAG患者及正常人视盘周围VD。采用受试者工作特征曲线(ROC)及ROC曲线下面积(AUC)评价视盘周围VD诊断POAG的效能。结果:与正常人相比,POAG患者视盘周围平均VD降低(P<0.001)。POAG患者视盘周围上方、下方的VD分别为52.38%±5.31%以及52.58%±5.32%。而对照组分别为58.43%±4.11%以及58.36%±3.40%(P<0.001)。多元线性回归分析结果显示杯盘比以及POAG诊断与视盘周围平均VD呈独立相关。ROC及AUC分析结果提示视盘周围平均VD的AUC值为0.808(95%CI:0.730~0.887)。结论:POAG患者视盘周围VD明显变小,变小的视盘周围VD与POAG诊断存在显著相关性。视盘周围VD可作为其它常规诊断青光眼的补充手段。

AIM:To investigate peripapillary vessel density(VD)in primary open angle glaucoma(POAG)eyes and to compare them with normal control eyes,and to evaluate the diagnostic ability of peripapillary VD in POAG.METHODS:Sixty consecutive POAG patients from March 2018 to December 2018 were enrolled in this study.Sixty age-and sex-matched healthy volunteer were also enrolled as a control group.Using RTVue-100 optical coherence tomography(OCT),the peripapillary VD of POAG eyes and normal control eyes were measured and compared.To assess the diagnostic ability of peripapillary VD in POAG,receiver operating characteristic curves(ROC)and areas under the ROC(AUC)were used.RESULTS:The POAG eyes had a smaller peripapillary VD than the control eyes overall(P<0.001).The mean superior and inferior peripapillary VD of the POAG patients were 52.38%±5.31%and 52.58%±5.32%,respectively.The mean superior and inferior peripapillary VD in control eyes were 58.43%±4.11%and 58.36%±3.40%,respectively.Compared to the normal control subjects,the POAG eyes had a smaller superior and inferior peripapillary VD with a significant difference(P<0.001).Multivariable linear regression analysis showed that cup/disc ratio and the peripapillary VD were significantly thinner in association with the POAG diagnosis.The ROC and AUC analyses showed that the AUC value of peripapillary VD is 0.808(95%CI:0.730-0.887)with a good diagnostic value.CONCLUSION:The peripapillary VD in POAG eyes was smaller than that of normal control eyes.Decreased peripapillary VD might therefore be associated with POAG.The peripapillary VD had a good diagnostic value.