Giusti C, Forte R, Vingolo E M
Institute of Ophthalmology, University "La Sapienza"--Rome (Italy).
Eur Rev Med Pharmacol Sci. 2002 Mar-Jun;6(2-3):45-8.
To define the main clinical mechanisms involved in the pathogenesis of macular holes (MH) in patients affected by Retinitis Pigmentosa (RP).
236 RP subjects were enrolled in this study and ophthalmologically examined according to a standard FIARP (Italian Federation of the RP Associations) protocol. The prevalence of posterior vitreous detachment (PVD) as well as all types of RP-related macular abnormalities--especially vitreoretinal interface alterations (VRIA), cystoid macular edema (CME), "bull's eye maculopathy" (BEM) and MH--was reported; statistical analyses and correlations were assessed by means of Student t test and Pearson chi2.
VRIA and CME were observed in 26.15% and 9.45% of the cases respectively and resulted significantly associated with MH, since they were constantly present in 22 of the 25 eyes affected by MH (88%) (chi2 = 50.4; p < 0.01). In particular, in 9 of these cases (40.9%) MH was correlated to both CME and VRIA, while in 11 (50%) and 2 (9.1%) eyes CME or VRIA were present separately. A normal biomicroscopic macular appearance, PVD and BEM were found in 26.81%, 6.6% and 21.54% of the cases respectively.
Further studies involving a larger number of patients are required to complete these preliminary results. However, the present investigation seem to confirm the data already reported in the literature, i.e. that pathogenesis of MH in RP is strictly correlated to the presence of VRIA, cellophane maculopathy and cystic foveal degeneration with CME.
明确视网膜色素变性（RP）患者黄斑裂孔（MH）发病机制中的主要临床机制。
236例RP患者纳入本研究，并根据标准的意大利视网膜色素变性协会联合会（FIARP）方案进行眼科检查。报告了玻璃体后脱离（PVD）以及所有类型的RP相关黄斑异常的患病率，尤其是玻璃体视网膜界面改变（VRIA）、黄斑囊样水肿（CME）、“靶心黄斑病变”（BEM）和MH；采用Student t检验和Pearson卡方检验进行统计分析和相关性评估。
分别在26.15%和9.45%的病例中观察到VRIA和CME，且与MH显著相关，因为在25只受MH影响的眼中，有22只（88%）始终存在VRIA和CME（卡方 = 50.4；p < 0.01）。特别是，在其中9例（40.9%）中，MH与CME和VRIA均相关，而在11只（50%）和2只（9.1%）眼中分别单独存在CME或VRIA。分别在26.81%、6.6%和21.54%的病例中发现黄斑外观正常、PVD和BEM。
需要进一步纳入更多患者的研究来完善这些初步结果。然而，目前的研究似乎证实了文献中已报道的数据，即RP中MH的发病机制与VRIA、黄斑视网膜病变和伴有CME的囊性黄斑变性密切相关。
