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목적 : To test the hypothesis that glaucomatous eyes with a single, localized choroidal microvasculature dropout (CMvD) are associated with greater amount of overall vessel density (VD) loss in the parapapillary choroid within ß-peripapillary atrophy (ßPPA) zone compared to those without CMvD
방법 : One hundred four eyes of 104 open-angle glaucoma (OAG) patients (52 eyes with and 52 eyes without CMvD) were enrolled. All subjects underwent optical coherence tomography angiography. We defined the peripapillary VD in the choroidal layer within ßPPA zone as choroidal circulatory index (CCI). The CCI including CMvD (CCI+) and excluding CMvD (CCI-) were measured using MATLAB software. The CCI between 2 groups were compared. The correlations between clinical variables including CMvD extent and CCI+/CCI- were estimated with univariate and multivariate linear regression analyses in the CMvD group
결과 : Both CCI+ and CCI- were significantly lower in the group with CMvD than without CMvD (p<0.05). The CMvD group showed lower average cpRNFLT than the group without CMvD despite having similar VF loss (p<0.05). Both CCI+ and CCI- were significantly correlated with CMvD angular extent, axial length, ßPPA/disc ratio, and global RNFLT in OAG eye with CMvD according to univariate linear regression analyses (p<0.05). In the multiple linear regression analysis, larger CMvD angular extent and larger PPA/disc ratio were significantly associated with lower CCI+ and CCI- values in OAG with CMvD (p<0.05).
결론 : Presence of CMvD can be a biomarker representing globally diminished perfusion in the parapapillary choroidal layer within ßPPA zone next to optic nerve head (ONH). As parapapillary choroid is closely linked to ONH perfusion, presence of CMvD in parapapillary choroidal layer may be an important clue to predict the diffuse ischemic damage to ONH.
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