METHODS: In this cross-sectional study, 84 participants were included, including 11 in the ocular hypertension (OHT) group, 11 in the preperimetric POAG (pre-POAG) group, 29 in the early POAG group and 33 in the control group. All participants underwent 6 × 6 mm2 scans of macula and optic nerved head by optic coherence tomography (OCT) and OCTA, along with white-on-white and blue-on-yellow VF testing by static automated perimetry. The ability of diagnosing early glaucoma by either various examinations separately or combination of examinations in both terms of function and structure was studied using the receiver operating characteristic (ROC) curve and the area under the curve (AUC).
RESULTS: The superficial retinal vessel densities (VD) in peri-nasal, para-temporal, peri-temporal and peri-inferior regions around the macula, as well as vessel area densities (VAD) in all peripapillary regions, were significantly different among the four groups, with lower VD or VAD in the early POAG patients compared to the normal individuals. The diagnostic ability of peripapillary superficial retinal VAD alone or VF testing alone was limited for early POAG only. However, the combination of these two was more effective in distinguishing normal individuals from OHT subjects or pre-POAG patients without VF defects, with better performance than the combination of peripapillary retinal nerve fiber layer (RNFL) thickness and VF indicators.
CONCLUSIONS: Peripapillary retinal vessel densities were generally lower in early POAG patients compared to normal individuals. The combination of peripapillary superficial retinal VAD by OCTA with white-on-white VF testing improved the ability to distinguish POAG patients at early stage without function impairment, which may help in providing reference and guidance for the following-up and treatment of suspected POAG patients.
方法:在这项横断面研究中,包括84名参与者,包括高眼压(OHT)组的11,在预测量POAG(pre-POAG)组中有11人,早期POAG组29例,对照组33例。通过光学相干断层扫描(OCT)和OCTA对所有参与者进行了6×6mm2的黄斑和光学神经头扫描。随着白色的白色和蓝色的黄色VF测试通过静态自动视野。使用受试者工作特征(ROC)曲线和曲线下面积(AUC)研究了通过单独进行各种检查或结合功能和结构检查来诊断早期青光眼的能力。
结果:鼻周视网膜浅表血管密度(VD),准时间性,黄斑周围的颞区和下部区域,以及所有乳头周围区域的血管面密度(VAD),四组之间有显著差异,与正常人相比,早期POAG患者的VD或VAD较低。仅对于早期POAG,单独的乳头周围浅表视网膜VAD或单独的VF测试的诊断能力有限。然而,两者的结合更有效地区分正常个体与OHT受试者或无VF缺陷的POAG前患者,表现优于结合乳头周围视网膜神经纤维层(RNFL)厚度和VF指标。
结论:与正常人相比,早期POAG患者的乳头周围视网膜血管密度普遍较低。通过OCTA与白色对白色VF测试相结合的乳头状周围浅表视网膜VAD提高了区分早期无功能损害的POAG患者的能力。有助于为疑似POAG患者的后续治疗提供参考和指导。