Background/aims To investigate the factors associated with choroidal microvasculature drop-out (MvD) enlargement detected by optical coherence tomography angiography (OCT-A) in glaucomatous eyes. Methods Ninety-one eyes of 68 primary open-angle glaucoma patients were enrolled. Only eyes with a minimum of four good quality OCT-A and OCT scans of the optic nerve head acquired at least and with a minimum of 2 years follow-up were included. Area and angular circumference of MvD were analysed on en face images. Univariable and multivariable mixed effects models were constructed to identify the factors contributing to MvD area and angular circumference change over time. Results Peripapillary MvD was detected in 53 (58.2%) eyes at baseline and in an additional 17 (18.6%) eyes during follow-up, whereas MvD was not detected in 21 (23.0 %) eyes during the entire follow-up period. In multivariable analysis, worse baseline visual field (VF) mean deviation (MD) (ß=0.27, 95% CI 0.10 to 0.44, p=0.002), greater intraocular pressure (IOP) fluctuations (ß=0.86, 95% CI 0.24 to 1.48, p=0.007), higher peak IOP (ß=0.17, 95% CI −0.01 to 0.35, p=0.067) and greater number of IOP lowering medications (ß=1.36, 95% CI 0.67 to 2.05, p<0.001) were associated with faster MvD area enlargement. Worse baseline VF MD and greater IOP fluctuation were also associated with significantly faster MvD circumferential enlargement in multivariable models. Conclusion Greater IOP fluctuation, higher peak IOP, worse baseline VF MD and greater number of glaucoma medications were significantly associated with MvD enlargement in glaucomatous eyes. The identification of factors associated with MvD enlargement may improve our understanding of the role of choroidal vasculature in glaucoma. Data are available on reasonable request.

中文翻译：

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脉络膜微血管脱落变化的相关因素

背景/目的 探讨青光眼眼光学相干断层扫描血管造影 (OCT-A) 检测到的脉络膜微血管脱落 (MvD) 增大的相关因素。方法 纳入原发性开角型青光眼患者68例91眼。仅纳入至少四次高质量 OCT-A 和至少获得视神经乳头 OCT 扫描且至少随访 2 年的眼睛。在正面图像上分析 MvD 的面积和角周长。构建了单变量和多变量混合效应模型，以确定导致 MvD 面积和角周长随时间变化的因素。结果 基线时 53 只眼 (58.2%) 检测到乳头周围 MvD，随访期间另外 17 只眼 (18.6%) 检测到 MvD，而整个随访期间 21 只眼 (23.0%) 未检测到 MvD。在多变量分析中，基线视野 (VF) 平均偏差 (MD) 较差（ß=0.27，95% CI 0.10 至 0.44，p=0.002），眼压 (IOP) 波动较大（ß=0.86，95% CI 0.24 至1.48，p=0.007），更高的峰值 IOP（ß=0.17，95% CI -0.01 至 0.35，p=0.067）以及更多的降 IOP 药物（ß=1.36，95% CI 0.67 至 2.05，p<0.001）与更快的 MvD 面积扩大有关。在多变量模型中，更差的基线 VF MD 和更大的 IOP 波动也与显着更快的 MvD 圆周扩大有关。结论 更大的眼压波动、更高的峰值眼压、更差的基线 VF MD 和更多的青光眼药物与青光眼眼 MvD 增大显着相关。识别与 MvD 增大相关的因素可能会提高我们对脉络膜血管系统在青光眼中作用的理解。可根据合理要求提供数据。