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色素性视网膜炎患者白内障手术后视网膜微结构与视力的关系。

Relationship between retinal microstructures and visual acuity after cataract surgery in patients with retinitis pigmentosa.

作者信息

Nakamura Yosuke, Mitamura Yoshinori, Hagiwara Akira, Kumagai Ken, Miura Gen, Sugawara Takeshi, Egawa Mariko, Yamamoto Shuichi

机构信息

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.

Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.

出版信息

Br J Ophthalmol. 2015 Apr;99(4):508-11. doi: 10.1136/bjophthalmol-2013-304819. Epub 2014 Oct 21.

Abstract

AIMS

To study the relationship between the retinal microstructures and the best-corrected visual acuity (BCVA) after cataract surgery in patients with retinitis pigmentosa (RP).

METHODS

58 eyes of 43 consecutive RP patients who underwent cataract surgery were studied. The BCVA was measured before and 3 months after the surgery. The appearance of the inner segment/outer segment (IS/OS) line of the photoreceptors in the optical coherence tomographic (OCT) images at the fovea was graded; Grade 1, IS/OS line not visible; Grade 2, IS/OS line abnormal or discontinuous; and Grade 3, IS/OS line normal. The central foveal thickness (CFT) and the length of the IS/OS line were measured in the spectral-domain OCT images.

RESULTS

The postoperative BCVAs in logMAR units (Grade 1, 1.04±0.36; Grade 2, 0.33±0.16; Grade 3, 0.08±0.14) and the improvements in the BCVA in logMAR units (Grade 1, 0.22±0.28; Grade 2, 0.53±0.48; Grade 3, 0.54±0.35) were significantly different among Grade 1, 2 and 3 groups (p<0.0001, p=0.0378; respectively). A postoperative BCVA of <0.2 logMAR units was achieved in 0% in Grade 1, 20% in Grade 2 and 74% in Grade 3 (p<0.0001). There was a significant correlation between the postoperative BCVA and the length of the IS/OS line (r=-0.601 p<0.0001) or the CFT (r=-0.510, p<0.0001).

CONCLUSIONS

The presence of normal IS/OS line in the OCT images is associated with good visual recovery after cataract surgery in RP patients. The integrity of the IS/OS line may be important for predicting good postoperative BCVA.

摘要

目的

研究色素性视网膜炎(RP)患者白内障手术后视网膜微观结构与最佳矫正视力(BCVA)之间的关系。

方法

对43例连续接受白内障手术的RP患者的58只眼睛进行研究。在手术前和手术后3个月测量BCVA。对光学相干断层扫描(OCT)图像中黄斑中心凹处光感受器的内节/外节(IS/OS)线的外观进行分级;1级,IS/OS线不可见;2级,IS/OS线异常或不连续;3级,IS/OS线正常。在光谱域OCT图像中测量中心凹黄斑厚度(CFT)和IS/OS线的长度。

结果

1级、2级和3级组术后BCVA的logMAR单位值(1级,1.04±0.36;2级,0.33±0.16;3级,0.08±0.14)及BCVA在logMAR单位值上的改善情况(1级,0.22±0.28;2级,0.53±0.48;3级,0.54±0.35)差异有统计学意义(分别为p<0.0001,p=0.0378)。1级患者术后BCVA<0.2 logMAR单位的比例为0%,2级为20%,3级为74%(p<0.0001)。术后BCVA与IS/OS线长度(r=-0.601,p<0.0001)或CFT(r=-0.510,p<0.0001)之间存在显著相关性。

结论

OCT图像中存在正常的IS/OS线与RP患者白内障手术后良好的视力恢复相关。IS/OS线的完整性对于预测术后良好的BCVA可能很重要。

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