Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Japan.
Eye (Lond). 2009 Feb;23(2):299-303. doi: 10.1038/sj.eye.6703077. Epub 2008 Mar 14.
The foveal function of patients with retinitis pigmentosa (RP) has been estimated by visual acuity (VA) or visual field (VF) tests. In the present study, the potential of optical coherence tomography (OCT) and focal electroretinogram (fERG) for monitoring macular function in RP patients was investigated.
Cross-sectional observational study.
A total of 56 eyes of 56 patients with RP underwent ophthalmic examination including VA, VF, fERG, and OCT. Patients were morphologically divided into three groups by the appearance of photoreceptor inner/outer segment junction (IS/OS) that were depicted with OCT; type 1: no IS/OS visible, type 2: IS/OS was visible but the length was < or =2 mm, and type 3: IS/OS >2 mm was confirmed. Functional results for VA and fERG were compared and analysed based on the three groups.
The average VA of type 1 patients was significantly lower than that of types 2 or 3 patients (P<0.001). There were no significant VA differences detected between types 2 and 3 patients. While most of the type 1 patients (21/22) showed non-recordable fERG, 3 out of 18 type 2 patients and none of type 3 patients showed non-recordable fERG. Significant differences of the fERG amplitudes were observed among the three groups (a-wave, b-wave, and OP, P<0.001 in all three components). However, the implicit time showed no difference between type 2 and 3.
Analysing the IS/OS with OCT and the amplitudes of fERG may be helpful for monitoring RP patients in addition to VA and VF.
通过视力(VA)或视野(VF)检查来评估色素性视网膜炎(RP)患者的中心凹功能。本研究旨在探讨光学相干断层扫描(OCT)和焦点视网膜电图(fERG)在监测 RP 患者黄斑功能中的应用价值。
横断面观察性研究。
对 56 例 RP 患者的 56 只眼进行眼科检查,包括 VA、VF、fERG 和 OCT。根据 OCT 显示的光感受器内外节连接(IS/OS)形态,将患者分为 3 组:1 型:不可见 IS/OS;2 型:可见 IS/OS,但长度≤2mm;3 型:可见 IS/OS,长度>2mm。根据这 3 组,对 VA 和 fERG 的功能结果进行比较和分析。
1 型患者的平均 VA 明显低于 2 型或 3 型患者(P<0.001)。2 型和 3 型患者之间的 VA 无显著差异。22 例 1 型患者中,21 例 fERG 无法记录,18 例 2 型患者中有 3 例 fERG 无法记录,而 3 型患者中无一例无法记录。三组间 fERG 振幅差异有统计学意义(a 波、b 波和 OP,所有三个分量均 P<0.001)。然而,2 型和 3 型间的 fERG 潜伏期无差异。
分析 OCT 的 IS/OS 和 fERG 的振幅除了 VA 和 VF 之外,可能有助于监测 RP 患者。