Purpose

To characterize the change rate of ganglion cell complex (GCC) thickness and macular vessel density in healthy, preperimetric glaucoma and primary open-angle glaucoma (POAG) eyes.

Design

Prospective, longitudinal study.

Participants

One hundred thirty-nine eyes (23 healthy eyes, 36 preperimetric glaucoma eyes, and 80 POAG eyes) of 94 patients who had at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was 2.0 years for healthy eyes, 2.6 years for preperimetric glaucoma eyes, and 2.6 years for POAG eyes.

Methods

OCT angiography (OCTA)-based vessel density and OCT-based structural thickness of the same 3×3-mm² GCC scan slab were evaluated. The dynamic range-based normalized rates of vessel density and thickness change were calculated and compared within each diagnostic group. The association between the rates of thickness and vessel density change and potential factors were evaluated.

Main Outcome Measures

The rates of GCC thinning and macular vessel density loss.

Results

Significant rates of GCC thinning and macular vessel density decrease were detectable in all diagnostic groups (all P < 0.05). In healthy eyes and preperimetric glaucoma eyes, the normalized rates of GCC thinning and macular vessel density decrease were comparable (all P > 0.1). In contrast, the normalized rate (mean, 95% confidence interval) of macular vessel density decrease in the POAG eyes (–7.12 [–8.36, –5.88]%/year) was significantly faster than GCC thinning (–2.13 [–3.35, –0.90]%/year; P < 0.001). In the POAG group, more than two thirds of the eyes showed faster macular vessel density decrease than GCC thinning; faster macular vessel density decrease rate was associated significantly with worse glaucoma severity (P = 0.037). The association between GCC thinning rate and glaucoma severity was not significant (P = 0.586). Intraocular pressure during follow-up significantly affected the rate of GCC thinning in all groups (all P < 0.05) but showed no association with the rate of macular vessel density decrease.

Conclusions

Both GCC thinning and macular vessel density decrease were detectable over time in all diagnostic groups. In POAG eyes, macular vessel density decrease was faster than GCC thinning and was associated with severity of disease. Macular vessel density is useful for evaluating glaucoma progression, particularly in more advanced disease.

中文翻译：

---

原发性开角型青光眼的神经节细胞复合体厚度和黄斑血管密度损失。

目的

表征健康、视野前青光眼和原发性开角型青光眼 (POAG) 眼中神经节细胞复合体 (GCC) 厚度和黄斑血管密度的变化率。

设计

前瞻性、纵向研究。

参与者

94 名至少接受过 3 次就诊的患者的 139 只眼（23 只健康眼、36 只眼周青光眼和 80 只 POAG 眼）纳入了诊断创新青光眼研究。健康眼的平均随访时间为 2.0 年，视野前青光眼眼为 2.6 年，POAG 眼为 2.6 年。

方法

评估了基于 OCT 血管造影 (OCTA) 的血管密度和基于 OCT 的相同 3×3-mm ² GCC 扫描板的结构厚度。在每个诊断组内计算并比较基于动态范围的血管密度和厚度变化的归一化率。评估了厚度和血管密度变化率与潜在因素之间的关联。

主要观察指标

GCC 变薄率和黄斑血管密度损失率。

结果

在所有诊断组中均可检测到 GCC 变薄和黄斑血管密度降低的显着比率（所有P < 0.05）。在健康眼和视野前青光眼眼中，GCC 变薄和黄斑血管密度降低的归一化率相当（均P > 0.1）。相比之下，POAG 眼黄斑血管密度降低的归一化率（平均，95% 置信区间）（–7.12 [–8.36，–5.88]%/年）明显快于 GCC 变薄（–2.13 [–3.35， –0.90]%/年；P < 0.001)。在 POAG 组中，超过三分之二的眼睛表现出比 GCC 变薄更快的黄斑血管密度下降；较快的黄斑血管密度下降率与较严重的青光眼严重程度显着相关（P = 0.037）。GCC 变薄率与青光眼严重程度之间的关联不显着（P  = 0.586）。随访期间眼压显着影响所有组的 GCC 变薄率（均P < 0.05），但与黄斑血管密度降低率无关。

结论

在所有诊断组中，随着时间的推移，可检测到 GCC 变薄和黄斑血管密度降低。在 POAG 眼中，黄斑血管密度下降比 GCC 变薄更快，并且与疾病的严重程度相关。黄斑血管密度可用于评估青光眼的进展，特别是在更晚期的疾病中。