Purpose

To determine whether microvasculature dropout (MvD) in the parapapillary choroid is related to the presence of central visual field defects in primary open-angle glaucoma (POAG).

Design

Cross-sectional observational study.

Participants

Thirty-two POAG patients with an initial parafoveal scotoma (IPFS) within a 10° radius in 1 hemifield and 42 POAG patients with an initial nasal step (INS) within the nasal periphery outside 10° of fixation in 1 hemifield.

Methods

The peripapillary choroidal microvasculature was evaluated on en face images obtained using swept-source OCT angiography. Microvasculature dropout was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the choroidal layer. Factors associated with IPFS, compared with INS, were assessed using logistic regression analyses.

Main Outcome Measures

Factors associated with IPFS rather than INS.

Results

Microvasculature dropout was observed in 25 of 32 eyes (78.1%) in the IPFS group, but in only 1 of 42 eyes (2.4%) in the INS group (P < 0.001). In logistic regression analyses, only MvD was a significant factor influencing the presence of IPFS. Systemic risk factors such as cold extremities (P = 0.026), migraine (P = 0.044), lower mean arterial pressure (P = 0.037), and lower ocular perfusion pressure (P = 0.024) were associated significantly with the presence of MvD.

Conclusions

The presence of MvD in the parapapillary choroid was a strong predictor for IPFS.

中文翻译：

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原发性开角型青光眼的中央视野损伤和乳头旁脉络膜微脉管系统的脱落。

目的

若要确定乳头旁脉络膜微血管丢失（MvD）是否与原发性开角型青光眼（POAG）中中央视野缺损的存在有关。

设计

横断面观察研究。

参加者

在1个半视野内，有10个半径在10°半径内的初始黄斑旁凹状囊炎（IPFS）的32例POAG患者，在1个半视野内，在10°固定范围外在鼻周边内有鼻腔初始台阶（INS）的42例POAG患者。

方法

在使用扫频OCT血管造影获得的全脸图像上评估了乳头周围脉络膜微脉管系统。微脉管系统脱落定义为局灶性扇形毛细血管脱落，在脉络膜层中未发现可见的微血管网络。与Logistic回归分析相比，与INS相比，与IPFS相关的因素进行了评估。

主要观察指标

与IPFS而不是INS相关的因素。

结果

IPFS组32眼中有25眼（78.1％）观察到微脉管系统脱落，而INS组42眼中只有1眼（2.4％）（P <0.001）。在逻辑回归分析中，只有MvD是影响IPFS存在的重要因素。MvD的存在与诸如四肢寒冷（P  = 0.026），偏头痛（P  = 0.044），较低的平均动脉压（P  = 0.037）和较低的眼部灌注压（P  = 0.024）等系统性危险因素显着相关。

结论

乳头旁脉络膜中MvD的存在是IPFS的重要预测指标。