| Objective:To study the effect of Tiluo Yangxue Mingmu prescription on optic nerve blood supply in POAG patients with stable intraocular pressure,and to reveal the mechanism of this prescription in improving optic nerve blood supply to improve visual function.Methods:This study was a prospective,self-controlled study.Through the optical coherence tomography angiography(OCTA),color Doppler flow imaging(CDFI),dynamic field of vision and best corrected visual acuity(BCVA)examination of patients with primary open Angle glaucoma(POAG)treated with Tiluo Yangxue Mingmu prescription and stable IOP control,the changes of the peripheral vascular density(VD),optic nerve fiber layer thickness(RNFLT),peak systolic blood flow velocity(PSV),end diastolic blood flow velocity(ED V),resistance index(RI)of ophthalmic artery(OA),central retinal artery(CRA)and posterior short ciliary artery(SPCA),and visual field MD and BCVA are investigated.The objective is to provide ideas for clinical treatment of primary open Angle glaucoma.A total of Sixty-one patients(Sixty-one eyes)who met the inclusion criteria in Eye hospital of Chinese Academy of traditional Chinese Medicine from September 2019 to January 2022 were selected.The treatment is to take Tiluo Yangxue Mingmu prescription plus or minus orally,2 times a day,1 bag once for 3 months.The changes of indexes were observed before and after treatment.Results:1.Visual field change:The MD of visual field before and after treatment were 13.17±8.04 and 10.76 ±7.29 respectively(P<0.05).2.visual changes:The BCVA of patients before and after treatment were 0.57 ±0.36 and 0.65 ±0.37 respectively(P<0.05).3.Blood flow change:(1)The vascular density of perioptic disc before and after treatment were:Whole image:38.16±9.59、41.92±9.04,Inside Disc:39.76±9.07、40.90±9.50,Peripapillary:36.42±8.81、37.82±13.58;Superior-Hemi:36.05±8.80、37.61±16.48;Inferior-Hemi:37.76±11.45、38.04±11.54;Nasal Superior:40.00±11.13、40.79±11.34;Nasal Inferior:39.40±11.13、40.87±11.70;Inferior Nasal:40.57±11.10、41.10±10.93;Inferior Tempo:38.62±11.59、39.14±11.99;Tempo Inferior:39.47±11.51、40.05±13.62;Tempo Superior:38.00±10.32、38.70±11.26;Superior Tempo:37.38±10.73、37.91±9.85;Superior Nasal:37.23±9.86、37.36±10.51。(P<0.05)(2)The ultrasonic hemodynamic indexes before and after treatment were:OA PSV:24.38±5.02、23.63±4.99;OA EDV:7.68±10.48、6.90±2.48;OA RI:0.72±0.12、0.72±0.11;CRA PSV:7.46±2.68、9.63±18.94;CRA EDV:2.87±1.24、2.79±1.08;CRA RI:0.58±0.12、0.58±0.12;SPCA PSV:9.59±1.98、9.56±1.99;SPCA EDV:3.57±0.86、3.54±0.85;SPCA RI:0.62±0.08、0.61±0.07(P>0.05)4.Changes of RNFL before and after treatment:;The thickness of RNFL around the optic disc is:Peripapillary:87.70±31.48、87.59±31.01;Superior-Hemi:90.49±32.24、87.93±32.03;Inferior-Hemi:86.75±34.18、86.02±32.79;Nasal Superior:88.51±3 0.80、84.44±28.29;Nasal Inferior:76.98±32.70、76.25±32.93;Inferior Nasal:93.44±48.00、93.66±48.94;Inferior Tempo:93.93±45.54、94.23±44.15;Tempo Inferior:68.75±25.06、68.30±23.54;Tempo Superior:73.23±26.70、73.10±27.18;Superior Tempo:87.21±31.75、84.48±30.31;Superior Nasal:92.02±34.58、94.36±39.84。(P>0.05)5.IOP changes before and after treatment:The thickness of RNFL around the optic disc is:15.66±3.16、15.76±3.24。(P>0.05)Conclusions:1.Tiluo Yangxue Mingmu prescription can improve the visual field MD and BCVA of POAG patients.2.Tiluo Yangxue Mingmu prescription can improve the vascular density around the optic disc.3.After the intervention of Tiluo Yangxue Mingmu prescription,the peak systolic flow velocity(PSV),end diastolic flow velocity(EDV)and resistance index(RI)of ophthalmic artery(OA),central artery(CRA)and short posterior ciliary artery(SPCA)were improved in some patients.4.The thickness of optic nerve fiber layer did not change significantly,and the difference was statistically significant,after the intervention of Tiluo Yangxue Mingmu prescription.5.The synchronous changes of hemodynamics,optic disc blood flow and visual function show that Tiluo Yangxue Mingmu prescription may improve the visual function of patients with primary open-angle glaucoma with collateral micro blood deficiency by improving the blood supply of optic nerve. |
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