The Application Study Of Optical Coherence Tomography In Primary Open-angle Glaucoma Patients With Macular Perfusion

Objectives:To investigate the changes of macular perfusion in primary open angle glaucoma and the correlation with glaucoma structural and functional parameters.Methods:We selected 54 eyes with POAG and 19 eyes with normal control eyes. Using Angio-OCT technology scans macular region for macular flow index and vessel density、 above and bottom of the vessel density, and GCC thickness、above and bottom of the GCC thickness、FLV、GLV. Using Humphrey field required threshold detection of 24-2、10-2 programs. Kruskal-wallis analysis were used to compare differences in macular perfusion parameters between the glaucoma group and the normal group.Spearman’s rank correlation statistical analysis were used to analyze the correlation between macular perfusion parameters and other glaucoma parameters, the significance level was set at P<0.05.Results:Compared to the normal controls, significant differences were found among diastolic blood pressure (DBP), mean arterial pressure, ocular perfusion pressure, trans-lamina cribrosa pressure in POAG patients, in normal control:ocular perfusion pressure:49.9±11.3, trans-lamina cribrosa pressure:-1.1±6.0, in glaucoma groups, ocular perfusion pressure:37.0±13, trans-lamina cribrosa pressure:7.2±8.2. But no differences were found among age, systolic blood pressure (SBP), body mass index (P>0.05). FI and vessel density have sindificant between normal subjects and glaucoma groups, vessel density in normal control:vessel density, in glaucoma groups is 41.4±4.7.4.7, with glaucoma patients increased vessel density and the GCC thickness gradually decreased. Analysis also showed that the vessel density were significantly correlated with the MD (R2=0.590, P=0.000). PSD (R2=0.501, P=0.000)以及GCC (R2=0.661, P=0.000) There were no correlation among FI and VF, but were negatively correlated with GCC (R2=-0.373, P=0.001). Ocular perfusion pressure OPP were not related to FI and vessel density in four groups(P> 0.05), trans-lamina cribrosa pressure only related with FI in mild glaucoma. The vessel density in normal subjects and early glaucoma was affected by age (P=0.012,0.039). The FI was affected by age (P=0.001,0.044), FI and blood vessel density were not affected by blood pressure and BMI. The area under the ROC curve of vascular density and GCC were 0.905 and 0.932, both of which were more than 0.9, which had good diagnostic performance in the diagnosis of glaucoma.Conclusions:In POAG patients vessel density was significantly lower than normal, and the lower level was associated with severity. Vessel density was closely related to VF MD, PSD and GCC thickness. The flow index was not related to the VF, and was negatively correlated with GCC. OPP and trans-lamina cribrosa pressure was not related to FI. Age is a risk factor for vessel density in normal and early glaucoma. In POAG patients macular vessel density decreased suggests that blood flow in glaucoma patients is not only in the optic disc, but also in the macular area. Angio-OCT can serve as an important tool used to measure blood flow in the eye, and have significance meaning in the application of ophthalmology.