Sun Jennifer K, Aiello Lloyd Paul, Stockman Margaret, Cavallerano Jerry D, Kopple Ann, Eagan Sharon, Qin Haijing, Kollman Craig, Beck Roy W, Glassman Adam R
Beetham Eye Institute and Eye Research Section, Joslin Diabetes Center, Boston, Massachusetts, USA.
Invest Ophthalmol Vis Sci. 2009 Apr;50(4):1580-4. doi: 10.1167/iovs.08-2426. Epub 2008 Oct 20.
To evaluate the effect of pupillary dilation on electronic-ETDRS visual acuity (EVA) in diabetic subjects and to assess postdilation EVA as a surrogate for predilation VA.
DRCR.net-protocol refraction and EVA were measured before and after dilation in diabetic subjects by independent, masked examiners.
In 129 eyes of 66 subjects, the median (25th, 75th percentiles) predilation EVA score was 69 (54, 86) (Snellen-equivalent 20/40(-1) [20/80(-1), 20/20(+1)]). Predilation VA was >or=20/20, <20/20 to 20/40, <20/40 to 20/80, and <20/80 in 29%, 19%, 26%, and 26% of eyes, respectively. Median EVA change postdilation was -3 letters (-7, 0). The absolute change in EVA score was >or=15 letters (>or=3 ETDRS lines) in 9% of eyes and >or=10 letters (>or=2 ETDRS lines) in 19% of eyes. Extent of change (range +12 to -25 letters) was associated with baseline VA. No relationship was identified between EVA change and gender, race, lens status, refractive error, DR severity, or primary cause of vision loss.
In an optimized clinical trial setting, there is a decline in best corrected EVA after dilation in diabetic subjects. The large range and magnitude of VA change preclude using postdilation EVA as a surrogate for undilated VA.
评估瞳孔散大对糖尿病患者电子ETDRS视力（EVA）的影响，并评估散瞳后的EVA作为散瞳前视力（VA）的替代指标。
由独立的、不知情的检查者在糖尿病患者散瞳前后测量DRCR.net方案的验光和EVA。
在66名受试者的129只眼中，散瞳前EVA评分的中位数（第25、75百分位数）为69（54，86）（Snellen等效值20/40（-1）[20/80（-1），20/20（+1）]）。散瞳前视力≥20/20、<20/20至20/40、<20/40至20/80以及<20/80的眼睛分别占29%、19%、26%和26%。散瞳后EVA变化的中位数为-3个字母（-7，0）。9%的眼睛EVA评分的绝对变化≥15个字母（≥3条ETDRS线），19%的眼睛≥10个字母（≥2条ETDRS线）。变化程度（范围+12至-25个字母）与基线视力相关。未发现EVA变化与性别、种族、晶状体状态、屈光不正、糖尿病视网膜病变严重程度或视力丧失的主要原因之间存在关联。
在优化的临床试验环境中，糖尿病患者散瞳后最佳矫正EVA会下降。视力变化的范围和幅度较大，因此不能将散瞳后的EVA作为未散瞳视力的替代指标。
