玻璃体黄斑病变特征患者手术前后的功能性黄斑图谱分析

Functional macular mapping in patients with vitreomacular pathologic features before and after surgery.

作者信息

Richter-Mueksch Sibylla, Vécsei-Marlovits Pia V, Sacu Stefan G, Kiss Christopher G, Weingessel Birgit, Schmidt-Erfurth Ursula

机构信息

Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.

出版信息

Am J Ophthalmol. 2007 Jul;144(1):23-31. doi: 10.1016/j.ajo.2007.03.045. Epub 2007 May 23.

DOI:10.1016/j.ajo.2007.03.045

PMID:17509512

Abstract

PURPOSE

To evaluate the potential benefit of microperimetry and preferential hyperacuity perimeter (PHP) to document visual performance objectively in patients with macular hole and macular pucker undergoing macular surgery.

DESIGN

Observational case series.

METHODS

In 19 patients with macular hole and 18 with macular pucker, best-corrected visual acuity (BCVA; in logarithm of the minimum angle of resolution units), central retinal sensitivity, and presence and extent of metamorphopsia were documented before and four and 12 weeks after surgery. Macular sensitivity (mean sensitivity decibel [dB], stability of fixation) was determined using MP1 microperimetry (Nidek, Padova, Italy). The PreView-PHP (Carl Zeiss Meditec, Dublin, California, USA) was used to quantify metamorphopsia.

RESULTS

Before surgery, mean BCVA was 0.68 +/- 0.25 (macular holes) and 0.58 +/- 0.25 (macular pucker). Microperimetry demonstrated a mean retinal sensitivity of 11.3 +/- 2.5 dB (macular holes) and 10.7 +/- 2.8 dB (macular pucker). Twelve weeks after surgery, mean BCVA improved to 0.53 +/- 0.26 (macular holes) and 0.33 +/- 0.26 (macular pucker; P = .042 and P = .004). Accordingly, retinal sensitivity increased significantly with 12.8 +/- 1.9 dB (macular holes) and 12.7 +/- 2.5 dB (macular pucker; P = .04 and P = .02) as well as stability of fixation. At 12 weeks, 47.3% of macular hole eyes and 66.7% of macular pucker eyes improved in BCVA, but a significantly higher number (68.4% [macular holes] and 77.8% [macular pucker]) demonstrated improvement in microperimetry results. PHP results showed no significant change of scotomas, patient reliability, or presence of metamorphopsia at any interval.

CONCLUSIONS

A higher number of patients improved in microperimetry than in visual acuity testing. Therefore, microperimetry highlights the value of functional macular mapping for these patients and indicates that BCVA may underestimate functional benefit of surgery.

摘要

目的

评估微视野计和优先超敏锐度视野计（PHP）在记录黄斑裂孔和黄斑皱襞患者接受黄斑手术后客观视觉功能方面的潜在益处。

设计

观察性病例系列。

方法

对19例黄斑裂孔患者和18例黄斑皱襞患者，在手术前、术后4周和12周记录最佳矫正视力（BCVA；以最小分辨角对数单位表示）、视网膜中央敏感度以及视物变形的存在情况和范围。使用MP1微视野计（意大利帕多瓦尼德克公司）测定黄斑敏感度（平均敏感度分贝[dB]，注视稳定性）。使用PreView-PHP（美国加利福尼亚州都柏林卡尔蔡司医疗技术公司）量化视物变形。

结果

手术前，平均BCVA在黄斑裂孔患者中为0.68±0.25，在黄斑皱襞患者中为0.58±0.25。微视野计显示黄斑裂孔患者的平均视网膜敏感度为11.3±2.5 dB，黄斑皱襞患者为10.7±2.8 dB。手术后12周，平均BCVA改善至黄斑裂孔患者为0.53±0.26，黄斑皱襞患者为0.33±0.26（P = 0.042和P = 0.004）。相应地，视网膜敏感度显著增加，黄斑裂孔患者为12.8±1.9 dB，黄斑皱襞患者为12.7±2.5 dB（P = 0.04和P = 0.02），注视稳定性也增加。在12周时，47.3%的黄斑裂孔眼和66.7%的黄斑皱襞眼的BCVA有所改善，但微视野计结果改善的患者比例显著更高（黄斑裂孔患者为68.4%，黄斑皱襞患者为77.8%）。PHP结果显示在任何时间间隔，暗点、患者可靠性或视物变形的存在均无显著变化。