原发性闭角型青光眼患者神经纤维层厚度分布特点与脉络膜毛细血管缺失的关系OA

Objective To explore the distribution characteristics of the retinal nerve fiber layer(RNFL)in patients with primary angle closure glaucoma(PACG)and analyze its relationship with choroidal microvasculature dropout(CM-vD).Methods Seventy-six patients(76 eyes)with PACG treated in our hospital from December 2020 to December 2024 were selected as the research subjects.According to whether the choriocapillaris were missing,the patients were divided in-to the CMvD group(32 eyes)and the non-CMvD group(44 eyes).Another 30 healthy individuals(30 eyes)who underwent physical examination in our hospital during the same period were selected as the control group.The clinical data,RNFL thickness,and optic disc parameters were compared among the three groups of patients.A multivariate logistic regression model was used to analyze the factors related to the CMvD occurrence in patients.Pearson correlation analysis was used to examine the correlation between RNFL thickness,optic disc parameters,and visual field mean deviation(MD).A restricted cubic spline was used to analyze the nonlinear association between RNFL thickness and the occurrence of CMvD in PACG patients.Log-binomial regression was used to analyze the risk of CMvD in different RNFL thicknesses and different ages.The differences in measured values among the groups were also compared.Results There were statistically significant differences in age,axial length,place of residence,and the proportion of myopic patients among the three groups(all P＜0.05).The CMvD group had more patients aged,residing in rural areas,and with myopia compared to the control group,while the axial length was significantly lower than that in the control group(all P＜0.05).The differences in superior,temporal,inferior,nasal,and mean RNFL thickness among the three groups were statistically significant(all P＜0.05).The superior,temporal,inferior,nasal,and mean RNFL thickness,as well as the circumpapillary vessel density(cpVD)in the CMvD group and the non-CMvD group were significantly lower than those in the control group,and the superior,temporal,inferior,nasal,and mean RNFL thickness,as well as cpVD in the CMvD group were significantly lower than those in the non-CMvD group(all P＜0.05).Statistically significant differences were observed in the cup volume(CV),rim area(RA),mean cup-to-disk ratio(C/D),vertical C/D,horizontal C/D,and visual field MD among the three groups(all P＜0.05).The CV,mean C/D,vertical C/D,and horizontal C/D in the CMvD group and the non-CMvD group were significantly higher than those in the control group,while the RA and visual field MD were significantly lower than those in the control group;and the CV,mean C/D,vertical C/D,and horizontal C/D in the CMvD group were significantly higher than those in the non-CMvD group,while the RA and visual field MD were significantly lower than those in the non-CMvD group(all P＜0.05).Pearson correlation analysis showed that the mean RNFL thickness in the optic disc and retina of patients was negatively correlated with the CV,mean C/D,vertical C/D,and horizontal C/D,and positively correlated with mean cpVD,RA,and visual field MD(all P＜0.05).Multivariate logistic regression analysis showed that age and mean RNFL thickness were related factors for the occurrence of CMvD in PACG patients(both P＜0.05).The restricted cubic spline regression analysis showed that mean RNFL thickness was significantly negatively correlated with the occurrence of CMvD in PACG patients(P＜0.05).Log-bino-mial regression analysis showed that in patients with a mean RNFL thickness＜81.53 μm,the incidence of CMvD in patients aged ≥ 62 years was significantly higher than that in patients aged＜62 years(P＜0.05).The repeatability and consistency test results showed that CMvD and RNFL had good repeatability and consistency in range and position.Conclusion The thickness of RNFL is closely related to the occurrence of CMvD in PACG patients.Clinical attention should be focused on patients with abnormal RNFL thickness,and personalized intervention strategies should be developed to improve their quali-ty of life.