原发性开角型青光眼患者光学相干断层扫描血管成像的临床特征
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摘要
目的观察原发性开角型青光眼患者光学相干断层扫描血管成像的临床特征。方法采用横断面研究设计,对佛山市第二人民医院眼科中心中诊断为原发性开角型青光眼患者进行光学相干断层扫描血管成像检查,获取视神经纤维层厚度及视盘周围血管密度等参数,正常对照组进行相同检查;采用Stata 12.0统计学软件进行数据整理和分析。结果共有44例纳入本次研究,其中病例组23例,对照组21例。两组患者在性别,年龄,人工晶体眼,糖尿病,高血压等对比均无差异。对照组平均视神经纤维厚度为(114.7±10.5)μm,病例组为(63.8±12.4)μm,差异有统计学意义;对照组视盘平均血管密度(48.3±2.6),而病例组视盘平均血管密度为(34.9±6.4),差异有统计学意义。统计分析对照组与病例组在各个区域视神经纤维层厚度与血管密度比较差异有统计学意义。上方及下方神经纤维层厚度及血管密度变化最大,其次为鼻侧,颞侧变化最小。结论原发性开角型青光眼患者视神经纤维层厚度及视盘周围血管密度明显下降,其中上方及下方血管密度下降最大,其次为鼻侧,颞侧变化最小。
Objective To observe the clinical characteristics of optical coherence tomography angiography in patients with primary open angle glaucoma.Methods Through using cross-sectional study,the patients diagnosed as primary open angle glaucoma inthe Ophthalmic Center of the Second People's Hospital of Foshan were examined by optical coherence tomography. Retinal nerve fi-ber layer thickness and Peripapillary capillary density were obtained. The normal control group was examined by the same examination.Stata 12.0 statistical software was used for data collation and analysis.Results A total of 44 people were included in the study,amongwhom 23 were in case group and 21 were in control group. There was no difference in gender,age,intraocular lens and diabetes andhypertension between the two groups. The average of retinal nerve fiber layer thickness in the control group was(114.7±10.5)μm,and in the case group was(63.8±12.4)μm. There was significant difference. The average of peripapillary capillary density in the con-trol group was(48.3±2.6),while the average in peripapillary capillary density in the case group was(34.9±6.4). The statistical analy-sis was significantly different. Statistical analysis showed that there was a significant difference between the control group and the casegroup in retinal nerve fiber layer thickness and Peripapillary capillary density in every area. There was statistically significant differ-ence. The changes of retinal nerve fiber layer thickness and peripapillary capillary density at the superior and inferior were the largest,followed by the nasal,and the temporal was the smallest.Conclusion Retinal nerve fiber layer thickness and peripapillary capillarydensity in the patients with primary open angle glaucoma decreased obviously,and peripapillary capillary density decreased most in the superior and inferior,followed by the nasal. The temporal was the smallest.
Objective To observe the clinical characteristics of optical coherence tomography angiography in patients with primary open angle glaucoma.Methods Through using cross-sectional study,the patients diagnosed as primary open angle glaucoma inthe Ophthalmic Center of the Second People's Hospital of Foshan were examined by optical coherence tomography. Retinal nerve fi-ber layer thickness and Peripapillary capillary density were obtained. The normal control group was examined by the same examination.Stata 12.0 statistical software was used for data collation and analysis.Results A total of 44 people were included in the study,amongwhom 23 were in case group and 21 were in control group. There was no difference in gender,age,intraocular lens and diabetes andhypertension between the two groups. The average of retinal nerve fiber layer thickness in the control group was(114.7±10.5)μm,and in the case group was(63.8±12.4)μm. There was significant difference. The average of peripapillary capillary density in the con-trol group was(48.3±2.6),while the average in peripapillary capillary density in the case group was(34.9±6.4). The statistical analy-sis was significantly different. Statistical analysis showed that there was a significant difference between the control group and the casegroup in retinal nerve fiber layer thickness and Peripapillary capillary density in every area. There was statistically significant differ-ence. The changes of retinal nerve fiber layer thickness and peripapillary capillary density at the superior and inferior were the largest,followed by the nasal,and the temporal was the smallest.Conclusion Retinal nerve fiber layer thickness and peripapillary capillarydensity in the patients with primary open angle glaucoma decreased obviously,and peripapillary capillary density decreased most in the superior and inferior,followed by the nasal. The temporal was the smallest.
引文
[1] FOSTER P J,BUHRMANN R,QUIGLEY H A,et al. The def-inition and classification of glaucoma in prevalence surveys[J].Br J Ophthalmol,2002,86:238-242.
[2] HE M,FOSTER P J,GE J,et al. Prevalence and clinical char-acteristics of glaucoma in adult Chinese:a populationbasedstudy in Liwan District, Guangzhou[J]. Invest Ophthalmol VisSci,2006,47:2782-2788.
[3] KASS M A,HEUER D K,HIGGINBOTHAM E J,et al. TheOcular Hypertension Treatment Study:a randomized trial deter-mines that topical ocular hypotensive medication delays or pre-vents the onset of primary open-angle glaucoma[J]. Arch Oph-thalmol,2002,120:701-713;829-730.
[4] IWASE A,SUZUKI Y,ARAIE M,et al. The prevalence of pri-mary open-angle glaucoma in Japanese:the Tajimi Study[J].Ophthalmology,2004,111:1641-1648.
[5] ANDERSON D R. Collaborative normal tension glaucoma study[J]. Curr Opin Ophthalmol,2003,14:86-90.
[6] CHIHARA E. Myopia and diabetes mellitus as modificatory fac-tors of glaucomatous optic neuropathy[J]. Jpn J Ophthalmol,2014,58:16-25.
[7] RIM T H,LEE S Y,BAE H W,et al. Increased risk of open-angle glaucoma among patients with diabetes mellitus:a 10-year follow-up nationwide cohort study[J]. Acta Ophthalmol,2018,96(8):1025-1030.
[8] TIELSCH J M, KATZ J, SOMMER A, et al. Hypertension,perfusion pressure,and primary open-angle glaucoma. A popu-lation-based assessment[J]. Arch Ophthalmol, 1995, 113:216-221.
[9] ZHENG Y,WONG T Y,MITCHELL P,et al. Distribution ofocular perfusion pressure and its relationship with open-angleglaucoma:the singapore malay eye study[J]. Invest OphthalmolVis Sci,2010,51:3399-3404.
[10] JIA Y, TAN O, TOKAYER J, et al. Split-spectrum ampli-tude-decorrelation angiography with optical coherence tomogra-phy[J]. Opt Express,2012,20:4710-4725.
[11] LEE E J,LEE K M,LEE S H,et al. OCT Angiography of thePeripapillary Retina in Primary Open-Angle Glaucoma[J]. In-vest Ophthalmol Vis Sci,2016,57:6265-6270.
[12] WANG X,JIANG C,KO T,et al. Correlation between opticdisc perfusion and glaucomatous severity in patients with open-angle glaucoma:an optical coherence tomography angiographystudy[J]. Graefes Arch Clin Exp Ophthalmol, 2015, 253:1557-1564.
[13] YARMOHAMMADI A,ZANGWILL L M,DINIZ-FILHO A,et al. optical coherence tomography angiography vessel densityin healthy, glaucoma suspect, and glaucoma eyes[J]. InvestOphthalmol Vis Sci,2016,57:451-459.
[14] AKAGI T, IIDA Y, NAKANISHI H, et al. Microvasculardensity in glaucomatous eyes with hemifield visual field de-fects:an optical coherence tomography angiography study[J].Am J Ophthalmol,2016,168:237-249.
[15] XU S,HUANG S,LIN Z,et al. Color doppler imaging analysisof ocular blood flow velocities in normal tension glaucoma pa-tients:a meta-analysis[J]. J Ophthalmol,2015(10):919610.
[16] GALASSI F,NUZZACI G,SODI A,et al. Possible correla-tions of ocular blood flow parameters with intraocular pressureand visual-field alterations in glaucoma:a study by means ofcolor Doppler imaging[J]. Ophthalmologica,1994,208:304-308.
[17] ALNAWAISEH M,MULLER V,LAHME L,et al. Changesin flow density measured using optical coherence tomographyangiography after istent insertion in combination with phaco-emulsification in patients with open-angle glaucoma[J]. J Oph-thalmol,2018(1):2890357.
[18] YARMOHAMMADI A,ZANGWILL L M,MANALASTAS P IC, et al. Peripapillary and macular vessel density in patients with primary open-angle glaucoma and unilateral visual fieldloss[J]. Ophthalmology,2017,125(4):578-587.
[19] SHOJI T, ZANGWILL L M, AKAGI T, et al. Progressivemacula vessel density loss in primary open-angle glaucoma:alongitudinal study[J]. Am J Ophthalmol,2017,182:107-117.
[20] HOU H, MOGHIMI S, ZANGWILL L M, et al. Inter-eyeasymmetry of optical coherence tomography angiography vesseldensity in bilateral glaucoma,glaucoma suspect,and healthyeyes[J]. Am J Ophthalmol,2018,190:69-77.
[21] RAO H L,PRADHAN Z S,WEINREB R N,et al. A compar-ison of the diagnostic ability of vessel density and structuralmeasurements of optical coherence tomography in primary openangle glaucoma[J]. PLoS One,2017,12:e0173930.
[2] HE M,FOSTER P J,GE J,et al. Prevalence and clinical char-acteristics of glaucoma in adult Chinese:a populationbasedstudy in Liwan District, Guangzhou[J]. Invest Ophthalmol VisSci,2006,47:2782-2788.
[3] KASS M A,HEUER D K,HIGGINBOTHAM E J,et al. TheOcular Hypertension Treatment Study:a randomized trial deter-mines that topical ocular hypotensive medication delays or pre-vents the onset of primary open-angle glaucoma[J]. Arch Oph-thalmol,2002,120:701-713;829-730.
[4] IWASE A,SUZUKI Y,ARAIE M,et al. The prevalence of pri-mary open-angle glaucoma in Japanese:the Tajimi Study[J].Ophthalmology,2004,111:1641-1648.
[5] ANDERSON D R. Collaborative normal tension glaucoma study[J]. Curr Opin Ophthalmol,2003,14:86-90.
[6] CHIHARA E. Myopia and diabetes mellitus as modificatory fac-tors of glaucomatous optic neuropathy[J]. Jpn J Ophthalmol,2014,58:16-25.
[7] RIM T H,LEE S Y,BAE H W,et al. Increased risk of open-angle glaucoma among patients with diabetes mellitus:a 10-year follow-up nationwide cohort study[J]. Acta Ophthalmol,2018,96(8):1025-1030.
[8] TIELSCH J M, KATZ J, SOMMER A, et al. Hypertension,perfusion pressure,and primary open-angle glaucoma. A popu-lation-based assessment[J]. Arch Ophthalmol, 1995, 113:216-221.
[9] ZHENG Y,WONG T Y,MITCHELL P,et al. Distribution ofocular perfusion pressure and its relationship with open-angleglaucoma:the singapore malay eye study[J]. Invest OphthalmolVis Sci,2010,51:3399-3404.
[10] JIA Y, TAN O, TOKAYER J, et al. Split-spectrum ampli-tude-decorrelation angiography with optical coherence tomogra-phy[J]. Opt Express,2012,20:4710-4725.
[11] LEE E J,LEE K M,LEE S H,et al. OCT Angiography of thePeripapillary Retina in Primary Open-Angle Glaucoma[J]. In-vest Ophthalmol Vis Sci,2016,57:6265-6270.
[12] WANG X,JIANG C,KO T,et al. Correlation between opticdisc perfusion and glaucomatous severity in patients with open-angle glaucoma:an optical coherence tomography angiographystudy[J]. Graefes Arch Clin Exp Ophthalmol, 2015, 253:1557-1564.
[13] YARMOHAMMADI A,ZANGWILL L M,DINIZ-FILHO A,et al. optical coherence tomography angiography vessel densityin healthy, glaucoma suspect, and glaucoma eyes[J]. InvestOphthalmol Vis Sci,2016,57:451-459.
[14] AKAGI T, IIDA Y, NAKANISHI H, et al. Microvasculardensity in glaucomatous eyes with hemifield visual field de-fects:an optical coherence tomography angiography study[J].Am J Ophthalmol,2016,168:237-249.
[15] XU S,HUANG S,LIN Z,et al. Color doppler imaging analysisof ocular blood flow velocities in normal tension glaucoma pa-tients:a meta-analysis[J]. J Ophthalmol,2015(10):919610.
[16] GALASSI F,NUZZACI G,SODI A,et al. Possible correla-tions of ocular blood flow parameters with intraocular pressureand visual-field alterations in glaucoma:a study by means ofcolor Doppler imaging[J]. Ophthalmologica,1994,208:304-308.
[17] ALNAWAISEH M,MULLER V,LAHME L,et al. Changesin flow density measured using optical coherence tomographyangiography after istent insertion in combination with phaco-emulsification in patients with open-angle glaucoma[J]. J Oph-thalmol,2018(1):2890357.
[18] YARMOHAMMADI A,ZANGWILL L M,MANALASTAS P IC, et al. Peripapillary and macular vessel density in patients with primary open-angle glaucoma and unilateral visual fieldloss[J]. Ophthalmology,2017,125(4):578-587.
[19] SHOJI T, ZANGWILL L M, AKAGI T, et al. Progressivemacula vessel density loss in primary open-angle glaucoma:alongitudinal study[J]. Am J Ophthalmol,2017,182:107-117.
[20] HOU H, MOGHIMI S, ZANGWILL L M, et al. Inter-eyeasymmetry of optical coherence tomography angiography vesseldensity in bilateral glaucoma,glaucoma suspect,and healthyeyes[J]. Am J Ophthalmol,2018,190:69-77.
[21] RAO H L,PRADHAN Z S,WEINREB R N,et al. A compar-ison of the diagnostic ability of vessel density and structuralmeasurements of optical coherence tomography in primary openangle glaucoma[J]. PLoS One,2017,12:e0173930.