Department of Ophthalmology, University of Padova, Padova.
Can J Ophthalmol. 2013 Oct;48(5):386-93. doi: 10.1016/j.jcjo.2013.03.022.
To analyze correlation among microperimetry, inner and outer retinal layers, and fundus autofluorescence (FAF) changes in eyes with progressing geographic atrophy (GA) secondary to age-related macular degeneration.
Microperimetry, spectral-domain optical coherence tomography (SD-OCT), standard short-wavelength FAF (SW-FAF), and near-infrared-wavelength FAF (NIR-FAF) were performed for all patients at both baseline and follow-up visits. FAF pattern, integrity of photoreceptor inner segment/outer segment (IS/OS) junction, total retinal thickness (RT), inner retinal layers (IRL), and outer retinal layers (ORL) thickness changes of every microperimetry extrafoveal tested point were analyzed.
A total of 366 microperimetry tested points were analyzed (6 patients, 7 eyes). Mean retinal sensitivity significantly decreased (p = 0.0149), and the percentage of dense scotomas significantly increased (p = 0.0125). Mean RT and mean ORL thickness significantly decreased (both p < 0.0001). Mean IRL thickness significantly increased (p = 0.0001). The decrease of ORL thickness was inversely correlated to the IRL thinning (rho = -0.710). FAF pattern at baseline was correlated to RT and ORL thickness (both p < 0.0001) and was significantly correlated to the risk to evolve to dense scotoma during follow-up (p = 0.0001 at SW-FAF, p < 0.0001 at NIR-FAF). Tested points showing at baseline the loss of photoreceptor IS/OS junction had a greater risk for evolving to dense scotoma compared with those with intact photoreceptor IS/OS junction (odds ratio 3.56, 95% CI 2.41-5.27).
Retinal sensitivity changes are correlated to IRL and ORL thickness changes, and to photoreceptor IS/OS junction integrity. FAF patterns remain a relevant factor in predicting GA evolution. Microperimetry, SW-FAF and NIR-FAF, and SD-OCT should be combined to obtain adequate morphologic and functional prospective information.
分析与年龄相关性黄斑变性相关的进行性地图状萎缩（GA）患者的微视野、内、外视网膜层和眼底自发荧光（FAF）变化之间的相关性。
所有患者在基线和随访时均进行微视野检查、频域光学相干断层扫描（SD-OCT）、标准短波 FA（SW-FAF）和近红外 FA（NIR-FAF）。分析每个微视野超检查点的 FAF 模式、光感受器内节/外节（IS/OS）连接的完整性、总视网膜厚度（RT）、内视网膜层（IRL）和外视网膜层（ORL）厚度变化。
共分析了 366 个微视野检查点（6 名患者，7 只眼）。视网膜平均敏感度显著降低（p = 0.0149），致密暗点的比例显著增加（p = 0.0125）。平均 RT 和平均 ORL 厚度显著降低（均 p < 0.0001）。平均 IRL 厚度显著增加（p = 0.0001）。ORL 厚度的减少与 IRL 变薄呈负相关（rho = -0.710）。基线时的 FAF 模式与 RT 和 ORL 厚度相关（均 p < 0.0001），并与随访期间发生致密暗点的风险显著相关（SW-FAF 时为 p = 0.0001，NIR-FAF 时为 p < 0.0001）。与基线时光感受器 IS/OS 连接丧失的检查点相比，具有完整光感受器 IS/OS 连接的检查点发展为致密暗点的风险更高（优势比 3.56，95%CI 2.41-5.27）。
视网膜敏感度的变化与 IRL 和 ORL 厚度的变化以及光感受器 IS/OS 连接的完整性相关。FAF 模式仍然是预测 GA 进展的一个相关因素。微视野、SW-FAF 和 NIR-FAF 以及 SD-OCT 应结合使用，以获得充分的形态和功能前瞻性信息。
