원발폐쇄각환자에서 시신경유두주위 혈관 밀도와 전방구조간의 관계연구

Abstract

Purpose: The purpose was to investigate the relationship between peripapillary Optical Coherence Tomography angiography (OCTA) vessel density (VD) and anterior segment structures in primary angle closure glaucoma (PACG) eyes. Methods: This was a retrospective cross-sectional study. 33 eyes of acute PACG with unilateral angle closure attack and 39 eyes of chronic PACG were enrolled. The peripaillary VD was obtained using OCTA (AngioVue/RTVue-XR). The potential relationship was estimated between peripapillary VD and other glaucomatous measurements such as visual field (VF) sensitivity value and retinal nerve fiber layer (RNFL) thickness using Pearson correlation analysis. In phakic PACG eyes with laser peripheral iridotomy (LPI) treatment, linear regression model was used to evaluate the relationship between peripapillary VD and AS-OCT parameters. Results: The peripapillary retinal vessel density tended to be lower in the acute PACG eyes than in the chronic PACG eyes, but the reduction was not statistically significant (40.9± 10.3% versus 44.2±8.9%, respectively; p=0.148). In both acute and chronic PACG eyes, reduced peripapillary vessel density was significantly correlated with higher intraocular pressure (IOP) (r=-0.406, r=-0.424, respectively; p<0.05), higher VF pattern standard deviation (PSD) (r=-0.629, r=-0.665, respectively; p<0.001), lower VF mean deviation (MD) (r=0.768, r=0.718, respectively; p<0.001) and lower RNFL thickness (r=0.842, r=0.758, respectively; p<0.001). In linear regression analysis, low angle opening distance at 750μm anterior to scleral spur (AOD750) (β=0.458, p<0.05) was significantly associated with reduction of peripapillary vessel density in PACG eyes treated with LPI. Conclusions: Although IOP has been controlled, peripapillary retinal vessel density tended to be lower in acute PACG eyes compared to chronic PACG eyes. In PACG eyes, low anterior chamber angle width even after pupillary block was relieved by LPI may affect persistent reduction in peripapillary vessel density.