Newsome David A, Negreiro Manny
Retinal Institute of Louisiana, New Orleans, Louisiana, USA.
Curr Eye Res. 2009 Feb;34(2):162-70. doi: 10.1080/02713680802647654.
To determine the safety, sensitivity, and specificity of a novel flash photorecovery timing instrument with response verification in differentiating normal from abnormal maculae, and in detecting worsening macular disease.
Right and left eye photorecovery times were determined at baseline and after 5 min using a xenon arc, flash filtered for infrared, ultraviolet, and visible short wavelengths, delivered through an aperture in a hand-held tube. A push-button actuated timer and flash and stopped timer when lighted numbers became visible post-flash. A numeric keypad verified responses. Normal subjects (two eyes tested, n = 144; one eye tested, n = 108) ranged in age from 15 to 84. Photorecovery times were measured in one eye of subjects with small drusen and 20/20 acuity (53-55 correct ETDRS letters; n = 57); in both eyes of subjects with dry age-related macular degeneration (AMD; n = 118); wet AMD with (n = 19) or without (n = 17) macular fluid; and eyes of diabetics with background retinopathy with (n = 19) or without (n = 17) macular retinal thickening. Once-weekly photorecovery measurements for 6 months in each eye of 10 dry AMD subjects and 10 dry diabetic maculopathy subjects provided longitudinal data.
Normal subjects' mean right eye recovery time was 9.6 sec (+/- 1.9 SD); left 10.8 sec (+/- 1.0 SD). Photorecovery lengthened after age 55, nearly doubling that of young subjects by age 80. Macular edema, serous macular detachment, or worsened dry AMD were accompanied by prolonged photorecovery (p < .01). When abnormal new vessels or retinal thickening appeared in three serially followed patients, photorecovery at least doubled (p < .01). In all three, photorecovery prolongation occurred without clinical symptoms. None of the 499 tested subjects reported adverse events due to the flash testing.
These findings support the usefulness of a reproducible light flash macular vision recovery measurement as an indicator of macular pathology and worsening disease.
确定一种新型的具有反应验证功能的闪光光恢复计时仪器在区分正常与异常黄斑以及检测黄斑疾病恶化方面的安全性、敏感性和特异性。
使用氙弧灯，滤除红外、紫外和可见短波长光，通过手持管中的孔径进行照射，在基线和5分钟后测定右眼和左眼的光恢复时间。一个按钮启动定时器，闪光后当点亮的数字可见时停止定时器。数字键盘验证反应。正常受试者（测试双眼，n = 144；测试单眼，n = 108）年龄在15至84岁之间。在有小玻璃疣且视力为20/20（53 - 55个正确的ETDRS字母；n = 57）的受试者的一只眼中测量光恢复时间；在干性年龄相关性黄斑变性（AMD；n = 118）患者的双眼、有（n = 19）或无（n = 17）黄斑积液的湿性AMD患者的眼中以及有（n = 19）或无（n = 17）黄斑视网膜增厚的背景性视网膜病变糖尿病患者的眼中测量光恢复时间。对10名干性AMD患者和10名干性糖尿病性黄斑病变患者的每只眼睛进行为期6个月的每周一次光恢复测量，以提供纵向数据。
正常受试者右眼的平均恢复时间为9.6秒（±1.9标准差）；左眼为10.8秒（±1.0标准差）。55岁以后光恢复时间延长，到80岁时几乎是年轻受试者的两倍。黄斑水肿、浆液性黄斑脱离或干性AMD恶化伴有光恢复时间延长（p < 0.01）。在三名连续随访的患者中出现异常新生血管或视网膜增厚时，光恢复时间至少翻倍（p < 0.01）。在所有这三名患者中，光恢复时间延长均无临床症状。499名受试受试者中无一报告因闪光测试出现不良事件。
这些发现支持了可重复的闪光黄斑视觉恢复测量作为黄斑病变和疾病恶化指标的有用性。
