Purpose

To investigate longitudinal changes in rates of optic nerve head circumpapillary retinal nerve fiber layer (cpRNFL) thinning and vessel density loss in patients with primary open-angle glaucoma with or without a history of disc hemorrhage (DH).

Design

Observational cohort.

Methods

In this longitudinal study, 34 eyes with DH and 134 eyes without DH that had ≥1.5 years of follow-up and 3 optical coherence tomography and optical coherence tomography angiography follow-up scans were enrolled. A linear mixed-effects model was used to compare the rates of cpRNFL thinning and vessel density loss between DH and non-DH eyes.

Results

Rates of whole image capillary density loss were faster in the DH group compared with the non-DH group (mean difference [95% confidence interval] −0.32% [−0.59% to −0.04%] per year; P = .027). Faster mean rates of vessel density loss were found in the inferotemporal, inferonasal, and nasal sectors in eyes with DH than without DH (P < .05). There was no statistically significant difference in the global rate of cpRNFL thinning between the 2 groups (P = .679). The mean rate of cpRNFL thinning was faster in the DH group compared with the non-DH group only in the inferotemporal sector (mean difference [95% confidence interval] −1.01 μm (−1.62 μm to −0.40 μm) per year; P = .001).

Conclusions

Mean rates of vessel density loss between DH and non-DH eyes were different not only in the affected area but also in the other regions. In contrast, a significant difference in cpRNFL thinning between the 2 groups was detected only in the inferotemporal sector. Disc hemorrhage is an independent predictor of faster vessel density loss in glaucoma suspects and patients with primary open-angle glaucoma.

中文翻译：

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青光眼合并视盘出血的毛细血管周围视网膜神经纤维层变薄和毛细血管密度丢失率

目的

调查伴或不伴视盘出血 (DH) 病史的原发性开角型青光眼患者的视神经乳头周围视网膜神经纤维层 (cpRNFL) 变薄率和血管密度丢失率的纵向变化。

设计

观察队列。

方法

在这项纵向研究中，纳入了 34 只患有 DH 的眼睛和 134 只没有 DH 的眼睛，随访时间≥1.5 年，并进行了 3 次光学相干断层扫描和光学相干断层扫描血管造影随访扫描。使用线性混合效应模型比较 DH 和非 DH 眼的 cpRNFL 变薄率和血管密度损失率。

结果

与非 DH 组相比，DH 组的整个图像毛细血管密度损失率更快（平均差异 [95% 置信区间] 每年 -0.32% [-0.59% 至 -0.04%]；P  = .027）。与没有 DH 的眼睛相比，在 DH 眼的颞下、鼻下和鼻区发现血管密度损失的平均速度更快 ( P < .05)。两组之间的 cpRNFL 整体变薄率在统计学上没有显着差异 ( P  = .679)。与非 DH 组相比，DH 组的 cpRNFL 平均变薄率仅在颞下区更快（平均差 [95% 置信区间] -1.01 μm（-1.62 μm 至 -0.40 μm）每年；P  = .001）。

结论

DH 和非 DH 眼的平均血管密度损失率不仅在受影响的区域不同，而且在其他区域也不同。相比之下，仅在颞下区检测到两组之间 cpRNFL 变薄的显着差异。椎间盘出血是青光眼嫌疑人和原发性开角型青光眼患者血管密度更快下降的独立预测因子。