OCTA在原发性开角型青光眼中的应用

目的:采用光学相干断层扫描血管成像术(OCTA)观察正常人和原发性开角型青光眼(POAG)患者盘周毛细血管(RPC)层的视盘区血管密度情况,探讨该技术对POAG的诊断能力。方法:本研究为横断面研究,纳入明确诊断为POAG患者45例60眼,健康受试者48例60眼为正常对照组。采用OCTA技术对所有受检者视乳头区扫描,测量视乳头区RPC层血管密度和纵行C/D比值。Humphrey视野检测MD、PSD值。分析血管密度和C/D比值的相关性;采用ROC曲线和AUC评价患者血管密度各参数的诊断效能并进行成对比较。结果:血管密度随着青光眼的加重而降低,视盘内毛细血管密度和视盘内血管密度与MD值及PSD值相关性较弱,其它各血管密度参数与MD值及PSD值具有很强的相关性。全区域毛细血管密度、视乳头周围毛细血管密度、全区域血管密度、视乳头周围血管密度AUC>0.9,具有较高的诊断价值,各参数间均无差异(P>0.05);视盘内毛细血管密度、视盘内血管密度的诊断效力明显低于其它参数(均P<0.05),AUC分别为0.85、0.88。结论:与正常对照组相比,POAG组血管密度明显下降,并且随着病情进展而加重;视盘区血管密度是评估POAG患者结构损伤的良好指标,在POAG的诊断和随访中具有重要意义,而视盘内血管密度和毛细血管密度对POAG的诊断效能明显低于其它血管参数。

Application of OCTA in primary open angle glaucoma

AIM: To observe the vascular density of optic disc region in radial peripapillary capillaries(RPC)layer of normal people and primary open argle glaucoma(POAG)patients using OCTA, and to explore the diagnostic ability of this technique for POAG.

METHODS: This study was a cross-sectional study, including 45 patients(60 eyes)diagnosed as POAG and 48 healthy subjects(60 eyes)as normal control group. OCTA technique was used to scan the optic papilla area of all subjects, and the vascular density and longitudinal C/D ratio of RPC layer in optic papilla area were measured. Humphrey''s field of view detected MD and PSD values. The correlation between vascular density and other parameters was analyzed. ROC curve and AUC were used to evaluate the diagnostic efficacy of various parameters of vascular density in patients and were compared in pairs.

RESULTS: The vascular density decreases with the aggravation of glaucoma. The correlation between capillary density and vascular density in optic disc and MD and PSD values is weak. Other vascular density parameters have strong correlation with MD and PSD values. The whole image capillary density, peripapillary capillary density, whole image vascular density, peripapillary vascular density AUC>0.9 have high diagnostic value. There was no statistical difference between among the parameters(P>0.05). The diagnostic efficacy of inside disc capillary density and inside vascular density is significantly lower than that of other parameters AUC of 0.85 and 0.88 respectively(P<0.05).

CONCLUSION:Compared with the positive control group, the vascular density in POAG group decreased significantly and became more serious with the progress of the disease. Vascular density in optic disc region is a good indicator for evaluating structural damage in POAG patients, and is of great significance in diagnosis and follow-up of POAG. However, the diagnostic efficiency of inside disc vascular density and capillary density for POAG is obviously lower than other vascular parameters.