Changes of microvasculature in the macular area before and after the surgery of acute primary angle-closure glaucoma complicated by cataract:an optical coherence tomography angiography-based study
10.13389/j.cnki.rao.2024.0182
- VernacularTitle:合并白内障的原发性急性闭角型青光眼患者手术前后黄斑区微血管的变化:基于OCTA的研究
- Author:
Jing CHEN
1
;
Li HU
;
Guanfeng WANG
;
Shuangyong WANG
Author Information
1. 510150 广东省广州市,广州医科大学附属第三医院眼科广东省产科重大疾病重点实验室广东省妇产疾病临床医学研究中心
- Keywords:
acute primary angle-closure glaucoma;
phacoemulsification;
goniosynechialysis;
optical coherence tomo-graphy angiography;
macula;
vessel density;
foveal avascular zone
- From:
Recent Advances in Ophthalmology
2024;44(12):967-971
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the changes of microvasculature in the macular area before and after the surgery of acute primary angle-closure glaucoma(APACG)complicated by cataract by using optical coherence tomography angiogra-phy(OCTA).Methods In this retrospective study,23 patients(46 eyes)with APACG(one eye in acute attack and the other eye in preclinical stage)complicated by age-related cataract in both eyes admitted to our hospital from May to No-vember 2023 were selected as the research subjects.The 23 eyes in the acute attack were taken as the observation group,and the 23 contralateral eyes in the preclinical stage were taken as the control group.After the intraocular pressure was sta-bilized,eyes in the observation group underwent phacoemulsification with intraocular lens implantation and goniosynechial-ysis;two weeks later,eyes in the control group underwent phacoemulsification with intraocular lens implantation.The pa-rameters of the foveal avascular zone(FAZ),parafoveal and perifoveal retinal vessel density,and foveal choroidal capillary perfusion area were examined by OCTA before and after surgery.The results were analyzed statistically.Results Before the surgery,the uncorrected visual acuity in the observation group was lower than that in the control group,and the in-traocular pressure was higher than that in the control group(both P＜0.01).At1 week,1 month and 3 months after sur-gery,the uncorrected visual acuity was higher and the intraocular pressure was lower than that before surgery in the two groups(all P＜0.05).The FAZ area and perimeter in the observation group were bigger,but the FAZ circularity index was smaller than that in the control group before the surgery(all P＜0.05).At 1 week after the surgery,the FAZ perimeter in the observation group was bigger,and the FAZ circularity index in the observation group was smaller than that in the con-trol group(both P＜0.05).After the surgery,the FAZ area and perimeter of affected eyes in both groups showed a down-ward trend,while the FAZ circularity index showed an upward trend.Compared with the values before surgery,the FAZ area and perimeter decreased,but the FAZ circularity index increased in the two groups 3 months after the surgery(all P＜0.01).The parafoveal and perifoveal retinal vessel densities in the observation group were lower than those in the control group before and at different time points after the surgery(all P＜0.05).The foveal choroidal capillary perfusion area in the observation group was lower than that in the control group before and at different time points after the surgery(all P＜0.01).The foveal choroidal capillary perfusion area in both groups after surgery increased than that before surgery;3 months after the surgery,the foveal choroidal capillary perfusion area was higher than that before the surgery in the obser-vation group(P＜0.01),but there was no significant difference in that before and after surgery in the control group(P＞0.05).Conclusion The FAZ area and perimeter are bigger,the FAZ circularity index is smaller,and retinal vessel den-sity of the macular area and foveal choroidal capillary perfusion area are lower in the acute attack eyes than those of the preclinical eyes with APACG complicated by age-related cataract.Phacoemulsification with intraocular lens implantation and goniosynechialysis is safe and effective in the treatment of acute attack APACG eyes with cataracts.After the surgery,the FAZ area and perimeter will decrease,while the FAZ circularity index and the foveal choroidal capillary perfusion area will increase.OCTA provides a reference for a more objective evaluation of the changes in microvasculature in the macular area of APACG patients before and after surgery.
