Macular Microvasculature Asymmetry Analysis for Evaluating Open-Angle Glaucoma in Diabetic Retinopathy Patients Treated With Pan-Retinal Photocoagulation

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-05-23 DOI:10.1016/j.ajo.2025.05.016

Kee-Sup Park, Jung-Tae Kim, Min-Woo Lee

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引用次数: 0

Abstract

Purpose

To evaluate the usefulness of vertical asymmetry analysis of macular microvasculature for diagnosis of open-angle glaucoma (OAG) in diabetic retinopathy (DR) patients who have undergone pan-retinal photocoagulation (PRP).

Design

Retrospective, cross-sectional diagnostic evaluation.

Methods

DR patients with PRP were categorized into those without OAG (Group 1) and those with OAG (Group 2). Peripapillary retinal nerve fiber layer (pRNFL) thickness and macular vessel density (VD) were measured, and the vertical difference in pRNFL (vdRNFL) and VD (vdVD) was determined as the absolute difference between the superior and inferior sectors. Diagnostic performance was analyzed by calculating the area under the curve (AUC).

Results

Analyses included 128 eyes (Group 1: 68 and Group 2: 60). The mean pRNFL thickness was 93.9 ± 14.8 µm in Group 1 and 85.5 ± 14.4 µm in Group 2 (P = .009). The mean vdRNFL was 13.1 ± 10.9 µm in Group 1 and 14.4 ± 12.6 µm in Group 2 (P = .607). The mean VD was 15.9 ± 3.3 mm⁻¹ in Group 1 and 15.3 ± 2.6 mm⁻¹ in Group 2 (P = .380), whereas the vdVD was 0.6 ± 0.6 mm⁻¹ in Group 1 and 1.6 ± 1.4 mm⁻¹ in Group 2 (P < .001). The AUC for diagnostic accuracy was 0.812 for vdVD, significantly higher than that for other factors (all P < .001).

Conclusions

Relying on pRNFL thickness for OAG evaluation in PRP-treated patients is not recommended. Analysis of vertical microvasculature asymmetry can serve as a useful factor for diagnosing OAG.

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泛视网膜光凝治疗糖尿病视网膜病变开角型青光眼的黄斑微血管不对称性分析。

目的探讨黄斑微血管垂直不对称分析对糖尿病视网膜病变（DR）行全视网膜光凝治疗（PRP）后开角型青光眼（OAG）的诊断价值。设计回顾性、横断面诊断评价。方法将sdr合并PRP患者分为无OAG组（1组）和有OAG组（2组）。测量乳头周围视网膜神经纤维层（pRNFL）厚度和黄斑血管密度（VD），确定pRNFL （vdRNFL）和VD （vdVD）的垂直差值为上下段的绝对差值。通过计算曲线下面积（AUC）分析诊断效果。结果共纳入128只眼（1组68只，2组60只）。第1组pRNFL平均厚度为93.9±14.8 μm，第2组为85.5±14.4 μm （P = 0.009）。组平均vdRNFL为13.1±10.9 μm，组平均vdRNFL为14.4±12.6 μm （P = 0.607）。组平均VD为15.9±3.3 mm-1，组平均VD为15.3±2.6 mm-1 (P = 0.380)，组平均vdVD为0.6±0.6 mm-1，组平均vdVD为1.6±1.4 mm-1 （P < 0.001）。vdVD诊断准确率的AUC为0.812，显著高于其他因素（P < 0.001）。结论在prp治疗的患者中，不推荐依赖pRNFL厚度来评估OAG。垂直微血管不对称分析可作为诊断OAG的有用因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.