Abstract
OBJECTIVE To explore the relationship between retinal nerve fiber layer(RNFL)and optic disc hemodynamic changes in primary open-angle glaucoma(POAG)with high myopia(HM).METHODS A total of 87 POAG patients(168 eyes)admitted to Xi'an Aier Eye Hospital from March 2021 to February 2023 were enrolled.Based on the presence of HM,the patients were divided into an HM group(38 cases,73 eyes)and a non-HM group(49 cases,95 eyes).All patients underwent combined trabeculectomy.Best-corrected visual acuity(BCVA),intraocular pressure(IOP),cup-to-disc ratio(C/D),peripapillary vessel density(VD),and macular foveal avascular zone(FAZ)area were measured preoperatively and six months postoperatively.Peripapillary RNFL thickness was compared between groups preoperatively and at seven days,one month,three months,and six months postoperatively.The correlation between optic disc VD and RNFL thickness and their impact on prognosis were analyzed.RESULTS(1)BCVA,IOP,C/D,and FAZ:Preoperative BCVA and IOP were significantly higher in the HM group than in the non-HM group(tBCVA=5.762,tIOP=5.944,both P=0.000).At six months postoperatively,BCVA and IOP remained higher in the HM group(tBCVA=3.960,tIOP=6.799,both P=0.000).No significant differences were observed in C/D and FAZ between groups pretoperatively or postoperatively(P>0.05).(2)Optic disc VD and RNFL thickness:The comparison of optic disc VD and RNFL thickness between the two groups before and after surgery revealed both temporal and intergroup differences(P<0.05).Preoperatively,the HM group exhibited significantly lower optic disc VD in all quadrants and higher RNFL thickness compared to the non-HM group(P<0.05).At one week postoperatively,no statistically significant differences were observed in the optic disc VD of the temporal-superior,inferior-nasal,and nasal-inferior quadrants between the two groups(P>0.05).However,at all other time points,the HM group showed significantly lower optic disc VD in all quadrants compared to the non-HM group(P<0.05).Regarding RNFL thickness,the HM group demonstrated higher values in all quadrants at one week postoperatively compared to the non-HM group.However,at one and three months postoperatively,the HM group exhibited lower RNFL thickness in the nasal-superior and superior-temporal quadrants,and at six months postoperatively,lower thickness in all quadrants,with statistically significant differences(P<0.05).(3)Correlation between VD and RNFL:A significant positive correlation was observed in all quadrants at six months postoperatively(rSN=0.767,rNS=0.679,rST=0.578,rTS=0.778,rTI=0.593,rIT=0.671,rIN=0.578,rNI=0.748,all P=0.000).(4)Prognostic impact:At one-year follow-up,patients with lower VD(28.35%)had significantly higher recurrence rates than those with higher VD(7.24%)(Log-Rank χ2=36.578,P=0.000);Similarly,lower RNFL thickness(31.43%)correlated with higher recurrence rates compared to higher RNFL thickness(12.25%)(Log-Rank χ2=67.334,P=0.000).CONCLUSIONS In POAG patients with HM,RNFL thickened initially post-surgery but subsequently thinned,while optic disc VD declined continuously,aligning with RNFL trends.A positive correlation between VD and RNFL thickness was observed at six months postoperatively.关键词
高度近视/开角型青光眼/神经纤维层/视盘血流动力学变化Key words
high myopia/primary open-angle glaucoma/nerve fiber layer/optic disc hemo-dynamic changes分类
医药卫生
