Zahlava Jiri, Lestak Jan, Karel Ivan
Eye department of the Clinic JL, V Hurkach 1296, 158 00 Prague 5, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014 Dec;158(4):628-34. doi: 10.5507/bp.2013.017. Epub 2013 Mar 21.
The aim of the study was to analyse different clinical pictures in patients with progressive cone dystrophy (PCD), to compare these with the results of optical coherence tomography (OCT) and to evaluate the benefits of this method for diagnosis.
The group consisted of 16 patients (32 eyes) with PCD. All patients were examined for visual acuity, colour sense and visual field. We performed biomicroscopic examination, photo-documentation, fluorescein angiography, electrophysiological tests and OCT.
Using biomicroscopy and fluorescein angiography, we found changes in the retinal pigment epithelium ranging from barely detectable changes up to the typical bull's eye appearance. In all the eyes, OCT established statistically significant reduction in the thickness and structural changes in the neuroretina of the macula. Atrophy was evident especially in the outer nuclear layer, in the photoreceptor inner segment/outer segment junction and in the retinal pigment epithelium. Visual acuity was mainly dependent on the degree to which the continuity of the photoreceptor inner segment/outer segment junction layer was maintained. Eyes with better preserved neuroretinal structure in the fovea centralis had generally less reduced thickness of the retina and a better visual acuity.
OCT specifies the quantitative and qualitative changes in the macula and may contribute significantly to the diagnosis of the progressive cone dystrophy, particularly in the early stages of the disease which is difficult to diagnose.
本研究旨在分析进行性锥体细胞营养不良(PCD)患者的不同临床表现,将其与光学相干断层扫描(OCT)结果进行比较,并评估该方法在诊断中的益处。
该组包括16例PCD患者(32只眼)。所有患者均接受视力、色觉和视野检查。我们进行了生物显微镜检查、照相记录、荧光素血管造影、电生理测试和OCT检查。
通过生物显微镜检查和荧光素血管造影,我们发现视网膜色素上皮的变化范围从几乎难以察觉的变化到典型的靶心外观。在所有眼中,OCT显示黄斑神经视网膜厚度有统计学意义的降低以及结构改变。萎缩在外部核层、光感受器内节/外节交界处和视网膜色素上皮中尤为明显。视力主要取决于光感受器内节/外节交界层的连续性保持程度。中央凹神经视网膜结构保存较好的眼睛,视网膜厚度通常减少较少,视力也较好。
OCT明确了黄斑的定量和定性变化,可能对进行性锥体细胞营养不良的诊断有显著贡献,尤其是在难以诊断的疾病早期阶段。