Department of Ophthalmology, University of Rome “Sapienza,” “A. Fiorini” Hospital, Rome, Italy.
Am J Ophthalmol. 2011 Jan;151(1):106-11. doi: 10.1016/j.ajo.2010.07.026. Epub 2010 Nov 20.
PURPOSE: To investigate the relation between the optical coherence tomography (OCT) findings and retinal sensitivity in patients with retinitis pigmentosa (RP) by assessing the retinal thickness and retinal function using Fourier-domain OCT (FD-OCT) and microperimetry, respectively. DESIGN: Observational case series. METHODS: Fifty-nine patients (118 eyes) were enrolled, mean age 47 ± 14.8 years. Thirty-two healthy subjects (HS) were enrolled as a control group. Patients were assessed by means of FD-OCT and microperimetry. We analyzed the average foveal thickness (diameter of 1 mm centered on the point of fixation), the value of the retinal sensitivities corresponding to the 4 degrees centered on the fixation point, and logMAR visual acuity for regression analysis converted from Snellen chart. RESULTS: We distinguished 4 groups of RP patients according to the macular pattern seen on OCT images. The first group of 36 eyes, mean age of 33.5 ± 7.4 years, had no macular changes, mean best-corrected visual acuity (BCVA) of 0.95 ± 0.07, mean foveal thickness of 256.3 ± 9.14 μm, and mean retinal sensitivities inside the central 4 degrees of 19.27 ± 0.87 dB (P > .05 for all the values). The second group of 28 eyes, mean age 35.4 ± 6.3 years, showed clinical macular edema (CME) on OCT images with mean BCVA of 0.72 ± 0.22, mean foveal thickness of 363.5 ± 93.45 μm, and mean retinal sensitivity inside the central 4 degrees of 15.94 ± 3.6 dB (P < .01 for all the values). The third group of 26 eyes, mean age 50.8 ± 8.7 years, showed macular vitreoretinal traction on OCT images with a mean BCVA of 0.5 ± 0.2, mean foveal thickness of 337.1 ± 71.7 μm, and mean retinal sensitivity inside the central 4 degrees of 11.78 ± 3.09 dB (P < .01 for all the values). The last group of 28 eyes, mean age 52.1 ± 13.6 years, showed macular retinal thinning on OCT images with mean BCVA of 0.36 ± 0.15, mean foveal thickness of 174.2 ± 24.40 μm, and mean retinal sensitivity inside the central 4 degrees of 10.22 ± 3.82 dB (P < .01 for all the values). CONCLUSIONS: MP-1 and FD-OCT showed high sensitivity for identifying functional and structural macular abnormalities, respectively. Future studies should investigate the relationships among photoreceptor cell loss, retinal sensitivity, and fixation in patients with RP.
目的：通过使用傅里叶域光学相干断层扫描（FD-OCT）和微视野计分别评估视网膜厚度和视网膜功能，研究色素性视网膜炎（RP）患者的光学相干断层扫描（OCT）结果与视网膜敏感性之间的关系。
设计：观察性病例系列。
方法：共纳入 59 名患者（118 只眼），平均年龄为 47 ± 14.8 岁。纳入 32 名健康受试者（HS）作为对照组。通过 FD-OCT 和微视野计对患者进行评估。我们分析了平均黄斑中心凹厚度（以注视点为中心的 1 毫米直径）、以注视点为中心的 4 度处视网膜敏感性的数值以及转换自 Snellen 图表的 logMAR 视力。
结果：我们根据 OCT 图像上的黄斑模式将 RP 患者分为 4 组。第一组 36 只眼，平均年龄 33.5 ± 7.4 岁，黄斑无变化，最佳矫正视力（BCVA）平均为 0.95 ± 0.07，黄斑中心凹厚度平均为 256.3 ± 9.14μm，中央 4 度内的视网膜敏感性平均为 19.27 ± 0.87dB（所有值的 P >.05）。第二组 28 只眼，平均年龄 35.4 ± 6.3 岁，OCT 图像上显示临床黄斑水肿（CME），BCVA 平均为 0.72 ± 0.22，黄斑中心凹厚度平均为 363.5 ± 93.45μm，中央 4 度内的视网膜敏感性平均为 15.94 ± 3.6dB（所有值的 P <.01）。第三组 26 只眼，平均年龄 50.8 ± 8.7 岁，OCT 图像上显示黄斑玻璃体视网膜牵引，BCVA 平均为 0.5 ± 0.2，黄斑中心凹厚度平均为 337.1 ± 71.7μm，中央 4 度内的视网膜敏感性平均为 11.78 ± 3.09dB（所有值的 P <.01）。第四组 28 只眼，平均年龄 52.1 ± 13.6 岁，OCT 图像上显示黄斑视网膜变薄，BCVA 平均为 0.36 ± 0.15，黄斑中心凹厚度平均为 174.2 ± 24.40μm，中央 4 度内的视网膜敏感性平均为 10.22 ± 3.82dB（所有值的 P <.01）。
结论：MP-1 和 FD-OCT 分别具有高度的敏感性，可用于识别功能和结构的黄斑异常。未来的研究应探讨 RP 患者的光感受器细胞丢失、视网膜敏感性和注视之间的关系。
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