关键词: 原发性开角型青光眼, 视盘, 视网膜血管, 基于人群的研究

Abstract: Objective To study the associations between the retinal vessel diameters (RVD) and optic disc parameters (ODP) in adults aged 30 years and older in rural northern China. Design Population-based cross-sectional study. Participants Adults aged 30 years and older in rural Northern China. Eligible 4137 subjects (60.6%)，include 4097 non-glaucoma and 40 subjects with primary open-angle glaucoma (POAG) were included from the baseline population of 6830 participants in the Handan Eye Study. Methods RVD parameters, including central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured by the IVAN software and ODP, including cup area (CA), disc rim area (RA), and maximum cup depth (MCD) were measured by Heidelberg retinal tomography (HRTII). Univariate and multivariate analysis were used to analyze the relationship between RVD and ODP. Main Outcome Measures CRAE, CRVE, CA, RA, and MCD. Results Univariable analysis showed narrower RVD were significantly associated with larger CA (P<0.001), smaller RA (P<0.001), deeper MCD (P<0.001). Multivariable linear regression analysis showed CRAE were significantly associated with CRVE (P<0.001, β=0.50), MCD (P=0.001, β=-3.7) , the presence of diabetes (P=0.043, β=-2.0), the presence of hypertension (P<0.001, β=-6.5); CRVE was significantly associated with female (P<0.001, β=3.9), CRAE (P<0.001, β=1.1), axial length (P<0.001, β=-4.7), RA (P<0.001, β=4.7), the presence of hypertension (P<0.001, β=6.0). In the final model, a unit increase in MCD was associated with an average reduction of 3.7 μm in CRAE, while a unit decrease in RA was associated with a reduction of 4.7 μm in CRVE. Conclusion The association between RVD and ODP reminds that smaller disk rim area is related to the thinner retinal vein, and the deeper optic cup is related to the thinner retinal artery. This may provide an epidemialogical basis for the ischemic mechanism of glaucoma. (Ophthalmol CHN, 2023, 32: 233-239)

Key words: primary open angle glaucoma, optic disc, retinal vessel, population-based study