Loughman James, Ratzlaff Matthew, Foerg Brittany, Connell Paul
*Department of Optometry, School of Physics, College of Sciences and Health, Dublin Institute of Technology, Dublin, Ireland; †African Vision Research Institute, Faculty of Health Sciences, University of KwaZulu Natal, Durban, South Africa; and ‡Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.
Retina. 2014 May;34(5):1006-13. doi: 10.1097/IAE.0000000000000021.
Diabetic retinopathy can result in impaired photostress recovery time despite normal visual acuity and fundoscopic appearance. The Macular Degeneration Detector (MDD-2) is a novel flash photostress recovery time device. In this study, we examine the repeatability of the MDD-2 in normal and diabetic subjects.
One hundred and ninety one (90 women, 101 men) subjects were recruited and divided into 1 of the 3 study groups (normal controls, n = 40; diabetes no retinopathy, n = 98; nonproliferative diabetic retinopathy, n = 53). Photostress recovery time was measured three times in the study eye using the MDD-2, each measurement separated by a 5-minute interval.
Repeated measures analysis of variance revealed no statistically significant learning or fatigue effects on intrameasurement repeatability for any group. Photostress recovery time measures were broadly similar and typically not statistically significantly different between study groups. The coefficient of repeatability reached clinically acceptable levels once the initial photostress recovery time measure, which demonstrated increased variability and latency compared with all subsequent measures, was excluded.
The MDD-2 seems to provide repeatable photostress recovery time measurements among naive diabetic subjects. The device does not, however, seem capable of differentiating normal and nonproliferative diabetic eyes, and would not be suitable for inclusion in diabetic retinopathy screening protocol.
尽管视力和眼底检查外观正常，但糖尿病视网膜病变仍可导致光应激恢复时间受损。黄斑变性检测仪（MDD - 2）是一种新型的闪光光应激恢复时间检测设备。在本研究中，我们检测了MDD - 2在正常受试者和糖尿病患者中的重复性。
招募了191名受试者（90名女性，101名男性），并将其分为3个研究组中的1组（正常对照组，n = 40；无视网膜病变的糖尿病患者，n = 98；非增殖性糖尿病视网膜病变患者，n = 53）。使用MDD - 2在研究眼中测量光应激恢复时间3次，每次测量间隔5分钟。
重复测量方差分析显示，任何组在测量内重复性方面均无统计学上显著的学习或疲劳效应。光应激恢复时间测量结果大致相似，研究组之间通常无统计学上的显著差异。一旦排除初始光应激恢复时间测量值（与所有后续测量值相比，其变异性和潜伏期增加），重复性系数便达到了临床可接受水平。
MDD - 2似乎能在初诊糖尿病患者中提供可重复的光应激恢复时间测量值。然而，该设备似乎无法区分正常眼和非增殖性糖尿病眼，因此不适合纳入糖尿病视网膜病变筛查方案。
