青光眼视网膜血流密度与视野缺损程度的相关分析  

Correlation between retinal vascular density and visual field loss in primary chronic angle-closure glaucoma

作　　者：王情 林鸿[2] 姚贻华 朱益华[2] WANG Qing;LIN Hong;YAO Yihua;ZHU Yihua(Department of Ophthalmology,Quanzhou First Hospital,Fujian Medical University,Fujian Quanzhou 362000;Department of Ophthalmology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China)

机构地区：[1]福建医科大学附属泉州第一医院眼科,福建泉州362000 [2]福建医科大学附属第一医院眼科,福州350000

出　　处：《眼科学报》2021年第6期433-438,共6页Eye Science

基　　金：国家自然科学基金(81970789)。

摘　　要：目的:探讨原发性慢性闭角型青光眼(chronic primary angle-closure glaucoma,CPACG)患者的视网膜血流密度(vessel density,VD)与视野缺损程度的相关性。方法:光学相干断层血管成像技术(optical coherence tomography angiography,OCTA)测量89例(112眼)视野缺损的CPACG患者的黄斑区VD、视盘旁VD,分析VD与视野缺损程度的相关性。结果:视盘旁VD与视野缺损程度成负相关(r>–0.728,P<0.05)。黄斑浅层总VD的受试者工作曲线(receiver operating characteristic,ROC)及曲线下面积(area under the curve,AUC)为0.874。在控制年龄、眼压及视力的情况下,黄斑总浅层VD每降低1%,视野平均缺损(mean deviation,MD)值增加–0.639 dB。结论:CPACG患者VD与视野缺损呈线性负相关,OCTA可以方便无创地观察青光眼患者眼底血流情况,在视野缺损前发现视网膜VD降低,从而可以作为CPACG早期诊断的参考指标。Objective:To investigate the correlation between the retinal vessel density(VD)and the degree of visual field loss in chronic primary angle-closure glaucoma(CPACG).Methods:Eighty-nine CPACG patients(112 eyes)with different degrees of visual field loss were measured with optical coherence tomography angiography(OCTA)for macular VD and para-optic microcirculation VD,and the correlation between them and the degree of visual field defect were analyzed.Results:There was a negative correlation between the VD of the microcirculation in each zone next to the optic disc and the degree of visual field loss(r>–0.728,P<0.05).The receiver operating characteristic(ROC)and area under the curve(AUC)of the total VD of the superficial macula is 0.874.Under the condition of controlling age,intraocular pressure and vision,for every 1%decrease in the total superficial macular VD, the average visual field defect mean deviation (MD) value increases -0.639 dB. Conclusion: The VD of CPACG patients is linearly negatively correlated with visual field defects. OCTA can conveniently and non-invasively observe the blood flow of the fundus in patients with glaucoma. It is found that the retinal VD is reduced before visual field defects, which can be used as a reference index for early diagnosis of CPACG.

关 键 词：光学相干断层血管成像技术 原发性慢性闭角型青光眼 血流密度 视野缺损 

分 类 号：R775[医药卫生—眼科]