ObjectiveTo investigate the correlation of retinal blood vessel density with blood pressure and retinal thickness in the macular region of glaucoma. MethodsA retrospective study. From March 2019 to March 2022, 100 glaucoma patients of 100 eyes (glaucoma group) and 100 healthy people of 100 eyes (control group) diagnosed in Department of Ophthalmology of Luoyang First People's Hospital were included in the study. The patients in the glaucoma group were subdivided into the early, intermediate, and late groups based on the average visual field defect value, which were 38, 32, and 30 cases, respectively. Optical coherence tomography angiography was used to scan the macular area of the examined eyes in a 3 mm×3 mm area. The software automatically divided the retina within 3 mm of the macular central concavity into 2 concentric circles centered on the macular central concavity, which were the central concave area with a diameter of 1 mm and the paracentral concave area with a diameter of 1-3 mm. The blood flow density and retinal thickness of the superficial retinal capillary plexus in the nasal, temporal, inferior, and superior quadrants of the retina within 3 mm of the macula were measured. Blood pressure was measured at the brachial artery using an electronic sphygmomanometer. Comparisons between two groups were made by independent samples t test, and comparisons between multiple groups were made by one-way analysis of variance. Correlations between retinal blood flow density and blood pressure and retinal thickness were analyzed by Spearman's correlation analysis. ResultsThe retinal blood vessel density in the central fovea, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than that in the control group, and with the aggravation of the disease, the retinal blood vessel density in the central fovea, parafoveal, inferior and superior macular areas gradually decreased; the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than those in the control group, and with the aggravation of the disease, the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas gradually decreased, the differences were statistically significant (P＜0.05). Systolic and diastolic blood pressure were higher in the glaucoma group than in the control group, and they increased gradually as the disease worsened (P＜0.05). Spearman's correlation analyses showed that in glaucoma patients, the density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas was positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure (P＜0.05). ConclusionThe density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas are positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure.
ObjectiveTo compare the consistency and difference of non-mydriatic two-field 45° ultra-wide field Optos and Clarus500 fundus imaging in a large-scale diabetic retinopathy (DR) screening. MethodsA diagnostic methodology study. From November 2020 to August 2021, 526 eyes of 277 patients with type 2 diabetes who diagnosed in Department of Ophthalmology, Henan Provincial People's Hospital were included in the study. Among them, there were 175 males with 328 eyes and 102 females with 198 eyes; the age was 53±10 years old. The same experienced technician performed the non-mydriatic dual-field 45° fundus imaging and the non-mydriatic ultra-wide-angle imaging system Optos, Clarus500 single-field fundus imaging examination on the patient on the same day, and obtained the dual-field 45° fundus image and Optos, Clarus500 single-field fundus image. The Optos and Clarus500 single-field fundus images in the same area as the dual-field 45° fundus image were captured by Photoshop software, and the Optos and Clarus500 dual-field fundus images were obtained. Subsequently, two experienced ophthalmologists performed interpretation and DR grading of the 5 groups of images, respectively. Images with inconsistent grading results were interpreted by a third ophthalmologist and used as the final grading result. In order to avoid the mydriatic dual-field 45° imaging interpretation results as the standard, the consistency and detection rate difference of the two ultra-wide-angle imaging systems in the rapid DR screening results were evaluated. The weighted Kappa (κ) test was used to analyze the consistency of DR diagnosis between dual-field 45° fundus imaging and Optos and Clarus500 fundus imaging; χ2 test was used to compare the detection rates of DR between different imaging systems. ResultsCompared with the dual-field 45° fundus image, the Clarus500 single-field had a higher DR detection rate (χ2=24.965, P＜0.001), and the Optos dual-field fundus image had a lower DR detection rate (χ2=49.559, P＜0.001). Compared with the DR detection rate of dual-field 45° fundus image, Optos single-field fundus image, Clarus500 double-field fundus image had no significant difference (χ2=2.572, 0.649; P=0.109, 0.421). Compared with Optos, Clarus500 single-field and dual-field fundus images DR detection rate, the difference was statistically significant (χ2=43.214, 61.216; P＜0.001). Consistency assessment of DR grading results: dual-field 45° fundus images and Clarus500 dual-field fundus images (κ value=0.932, 95% confidence interval (CI) 0.907-0.956) were highly consistent; dual-field 45° fundus images and Optos single-field fundus images [κ value=0.474, 95%CI 0.417-0.532], Optos dual-field fundus image (κ value=0.495, 95%CI 0.438-0.551), Optos dual-field fundus image (κ value=0.495, 95%CI 0.438-0.551) and Clarus500 dual-field fundus image (κ value=0.452, 95%CI 0.395-0.506) were moderately consistent; dual-field 45°fundus images and Clarus500 single-field fundus images (κ value=0.354, 95%CI 0.303-0.403) and Optos single-field fundus images and Clarus500 single-field fundus images (κ value=0.347, 95%CI 0.287-0.393) showed general agreement. ConclusionsCompared with Optos dual-field fundus image, dual-field 45°fundus image and Clarus500 dual-field fundus image have high consistency in the grading results of DR rapid screening. Compared with Optos single-field fundus image, the detection rate of the DR of Clarus500 single-field fundus image is higher.