Salvatore Serena, Fishman Gerald A, McAnany J Jason, Genead Mohamed A
*Department of Ophthalmology, University La Sapienza of Rome, Polo Pontino, Latina, Italy; †Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, Illinois; and ‡Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Retina. 2014 May;34(5):989-95. doi: 10.1097/IAE.0000000000000022.
To evaluate dark-adapted retinal sensitivity in patients with Stargardt disease (STGD1) using a modified MP-1 microperimeter and to compare the sensitivity loss with structural changes observed using spectral domain optical coherence tomography and confocal scanning laser ophthalmoscope infrared imaging.
Twelve STGD1 patients and 10 normally sighted controls participated. Dark-adapted mean sensitivity (MS) was obtained using a MP-1 microperimeter. Additionally, MS percent difference between the patients and the controls was obtained. Sensitivity results were superimposed on confocal scanning laser ophthalmoscope infrared images and compared with corresponding spectral domain optical coherence tomography scans.
Dark-adapted MS ± standard deviation was 8.34 ± 1.54 dB for the controls and 3.68 ± 1.74 dB for STGD1 patients (P < 0.001). There was a significant reduction in MS of 24.0% in these patients. Sensitivity reductions were observed in areas that showed changes on confocal scanning laser ophthalmoscope infrared images and on spectral domain optical coherence tomography, including disorganizational loss of the retinal pigment epithelium, and abnormal photoreceptor inner segment ellipsoid and external limiting membrane reflectance bands.
With topographical accuracy, dark-adapted MS measurements can be made in STGD1 patients and controls using the MP-1 microperimeter. Sensitivity loss is associated with structural changes. This finding can be useful for the determination of optimal areas for potential improvement of retinal function in patients with Stargardt disease.
使用改良的MP-1微视野计评估斯塔加特病（STGD1）患者的暗适应视网膜敏感度，并将敏感度损失与使用光谱域光学相干断层扫描和共焦扫描激光眼底镜红外成像观察到的结构变化进行比较。
12例STGD1患者和10名正常视力对照者参与研究。使用MP-1微视野计获得暗适应平均敏感度（MS）。此外，还获得了患者与对照者之间的MS百分比差异。将敏感度结果叠加在共焦扫描激光眼底镜红外图像上，并与相应的光谱域光学相干断层扫描进行比较。
对照组暗适应MS±标准差为8.34±1.54dB，STGD1患者为3.68±1.74dB（P<0.001）。这些患者的MS显著降低了24.0%。在共焦扫描激光眼底镜红外图像和光谱域光学相干断层扫描显示有变化的区域观察到敏感度降低，包括视网膜色素上皮组织紊乱性缺失以及光感受器内节椭圆体和外界膜反射带异常。
利用MP-1微视野计能够在STGD1患者和对照者中进行具有地形学准确性的暗适应MS测量。敏感度损失与结构变化相关联。这一发现有助于确定斯塔加特病患者视网膜功能潜在改善的最佳区域。
