Putnam Christopher M, Kinerk Wesley T, Bassi Carl J
University of Missouri-St. Louis College of Optometry, St. Louis, MO 63121, USA.
Optom Vis Sci. 2013 Jul;90(7):e206-12. doi: 10.1097/OPX.0b013e318299386e.
Macular pigment (MP) is the collective name for three isomeric carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. Macular pigment density is greatest in the central retina, peaking at the fovea and falling to negligible levels at 7 degrees of eccentricity from the fovea. Several studies have documented the interocular symmetry of MP optical density (MPOD) spatial distribution. The ongoing University of Missouri-St. Louis study uses a novel, customized heterochromatic flicker photometer to map the spatial distribution of MPOD up to 8 degrees of eccentricity relative to the fovea. Here, we report the MPOD measurements in a subject with resolved central serous chorioretinopathy (CSC) in the right eye.
Two subjects performed the full MPOD spatial mapping. The test subject (WK) had a history of central serous CSC of the right eye. The control subject (CP) had an unremarkable ocular health history. Comprehensive exams were performed on each subject including Cirrus optical coherence tomography imaging and fundus photographs. Subject CP showed highly symmetric interocular MPOD profiles at the fovea and 2, 4, and 6 degrees of eccentricity. Subject WK showed interocular asymmetry at the fovea and at 2 degrees with relative symmetry at 4 and 6 degrees. A paired sample t test identified nonsignificant interocular values for subject CP and statistically significant differences of at 2 degrees for subject WK.
We hypothesize that subject WK's interocular MPOD spatial distribution asymmetry resulted from his history of resolved CSC. This asymmetry is statistically significant at 2 degrees of retinal eccentricity and corresponds to the extent of retinal pigment epithelium changes observed on the fundus photographs. These findings suggest that MP and retinal pigment epithelium changes after a CSC episode are comparable in the area of the retina affected. These disruptions may also be measureable in other macular conditions in which the sensory retina is affected (e.g., cystoid macular edema and clinically significant macular edema).
黄斑色素(MP)是三种同分异构类胡萝卜素的统称:叶黄素、玉米黄质和内消旋玉米黄质。黄斑色素密度在视网膜中央最大,在中央凹处达到峰值,并在距中央凹7度偏心率处降至可忽略不计的水平。多项研究记录了MP光密度(MPOD)空间分布的双眼对称性。正在进行的密苏里大学圣路易斯分校的研究使用一种新型的、定制的异色闪烁光度计来绘制相对于中央凹高达8度偏心率的MPOD空间分布。在此,我们报告了一名右眼中心性浆液性脉络膜视网膜病变(CSC)已治愈患者的MPOD测量结果。
两名受试者进行了完整的MPOD空间测绘。受试对象(WK)有右眼中心性浆液性CSC病史。对照对象(CP)眼部健康史无异常。对每个受试者进行了全面检查,包括Cirrus光学相干断层扫描成像和眼底照片。受试者CP在中央凹以及2度、4度和6度偏心率处显示出高度对称的双眼MPOD分布。受试者WK在中央凹和2度处显示出双眼不对称,在4度和6度处相对对称。配对样本t检验确定受试者CP的双眼值无统计学意义,而受试者WK在2度处有统计学显著差异。
我们推测受试者WK的双眼MPOD空间分布不对称是由其已治愈的CSC病史导致的。这种不对称在视网膜偏心率2度处具有统计学意义,并且与眼底照片上观察到的视网膜色素上皮变化程度相对应。这些发现表明,CSC发作后MP和视网膜色素上皮的变化在受影响的视网膜区域具有可比性。在其他影响感觉视网膜的黄斑疾病(如黄斑囊样水肿和具有临床意义的黄斑水肿)中,这些破坏也可能是可测量的。