静态和动态视网膜固视稳定性的微视野检查。

Static and dynamic retinal fixation stability in microperimetry.

机构信息

G. B. Bietti Foundation, IRCCS, Roma, Italy.

出版信息

Can J Ophthalmol. 2013 Oct;48(5):375-80. doi: 10.1016/j.jcjo.2013.05.021.

DOI:10.1016/j.jcjo.2013.05.021

PMID:24093183

Abstract

OBJECTIVE

To compare static (during a pure fixation task) versus dynamic (during microperimetry) quantification of fixation stability using microperimetry in normal and pathologic eyes, by means of 2 available (clinical and bivariate contour ellipse area [BCEA]) classification methods.

DESIGN

Prospective comparative observational study.

PARTICIPANTS

One hundred and forty-nine eyes (110 patients) with different macular diseases and 171 normal eyes (109 subjects).

METHODS

In all eyes studied, fixation stability was acquired during an isolated fixation task (static fixation) and during microperimetry (dynamic fixation). All fixation data were analyzed and compared by means of a clinical classification and by means of BCEA quantification.

RESULTS

Pathologic eyes were classified as follows: 41 eyes with diabetic macular edema (DME group), 13 eyes with vitreoretinal interface disease, 60 eyes with age-related macular degeneration (AMD group), and 35 eyes with primary open-angle glaucoma. Fixation stability was not uniform among groups according to clinical classification in both static and dynamic modalities (p < 0.0001). AMD group showed larger BCEA areas compared with all other groups (p < 0.0001). All pathologic groups showed more unstable fixation in dynamic fashion according to both clinical and BCEA methods (p < 0.0001). The variation of fixation stability of control group in dynamic task was highlighted only by BCEA analysis (p < 0.0001). A deterioration of retinal fixation according to clinical method matches a significant increase in BCEA areas (p < 0.0001).

CONCLUSIONS

The detection of clinical fixation stability changes improves when acquired in the dynamic modality. BCEA analysis provides more accurate evaluation of fixation stability and may detect minimal quantitative changes of the fixation area. However, a standard clinical classification can also detect changes in fixation stability in pathologic eyes. Both methods are useful tools in the evaluation of fixation stability.

摘要

目的

通过两种现有的（临床和双变量轮廓椭圆面积 [BCEA]）分类方法，比较正常和病理眼中使用微视野计进行静态（在纯固视任务期间）和动态（在微视野计期间）固视稳定性的定量。

设计

前瞻性比较观察性研究。

参与者

149 只眼（110 例患者）患有不同的黄斑疾病和 171 只正常眼（109 例）。

方法

在所有研究的眼中，在孤立的固视任务期间（静态固视）和微视野计期间（动态固视）获取固视稳定性。通过临床分类和 BCEA 定量分析比较所有固视数据。

结果

病理眼分为以下几类：41 只糖尿病性黄斑水肿（DME 组），13 只玻璃体视网膜界面疾病，60 只年龄相关性黄斑变性（AMD 组）和 35 只原发性开角型青光眼。根据临床分类，静态和动态两种模式下，各组的固视稳定性并不均匀（p < 0.0001）。AMD 组的 BCEA 面积大于所有其他组（p < 0.0001）。根据临床和 BCEA 方法，所有病理组在动态模式下均显示出更不稳定的固视（p < 0.0001）。仅通过 BCEA 分析，对照组在动态任务中的固视稳定性变化更为明显（p < 0.0001）。根据临床方法，视网膜固视稳定性的恶化与 BCEA 面积的显著增加相匹配（p < 0.0001）。