Murakami Yusuke, Ikeda Yasuhiro, Akiyama Masato, Fujiwara Kota, Yoshida Noriko, Nakatake Shunji, Notomi Shoji, Nabeshima Takahiro, Hisatomi Toshio, Enaida Hiroshi, Ishibashi Tatsuro
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan.
Acta Ophthalmol. 2015 Dec;93(8):e644-8. doi: 10.1111/aos.12693. Epub 2015 Feb 17.
To investigate the changes in macular blood flow and the correlation between those changes and central visual function in patients with retinitis pigmentosa (RP).
The mean blur rate (MBR), a quantitative blurring index of the laser speckle pattern that represents retinal and choroidal blood flow, was measured by laser speckle flowgraphy. Mean blur rate values in the macular area were compared between 70 patients with RP and 28 control subjects. The relationships between MBR on the one hand and, on the other, visual acuity (VA), mean deviation (MD) and averaged macular sensitivity of static perimetry tests (Humphrey Filed Analyzer, the central 10-2 program) were analysed in patients with RP.
Macular MBR was decreased to 75% in patients with RP compared with control subjects (p < 0.0001, Student's t-test). Spearman's rank testing showed that macular MBR was significantly correlated with VA (r = -0.261, p = 0.0299), MD values (r = 0.438, p = 0.0002) and averaged macular sensitivity at the central 4 and 12 points of static perimetry tests (r = 0.426 and 0.442, p = 0.0003 and 0.0002, respectively). Multivariable-adjusted analysis confirmed that MBR was independently associated with MD (p = 0.0002) and macular sensitivity at the central 4 and 12 points (p < 0.0001 and 0.0002, respectively).
Decreased macular blood flow was associated with reduced macular visual sensitivity in patients with RP. Although the cause-effect relationships remain to be elucidated, these findings suggest that vascular defects may be involved in the pathogenesis of RP such as central vision loss.
研究视网膜色素变性（RP）患者黄斑血流的变化及其与中心视觉功能变化之间的相关性。
采用激光散斑血流图测量平均模糊率（MBR），这是一种代表视网膜和脉络膜血流的激光散斑图案定量模糊指数。比较70例RP患者和28例对照者黄斑区的平均模糊率值。分析RP患者中MBR与视力（VA）、平均偏差（MD）以及静态视野检查（Humphrey视野分析仪，中央10-2程序）的平均黄斑敏感度之间的关系。
与对照者相比，RP患者的黄斑MBR降低至75%（p<0.0001，Student t检验）。Spearman秩检验显示，黄斑MBR与VA（r=-0.261，p=0.0299）、MD值（r=0.438，p=0.0002）以及静态视野检查中央4点和12点的平均黄斑敏感度显著相关（r分别为0.426和0.442，p分别为0.0003和0.0002）。多变量调整分析证实，MBR与MD（p=0.0002）以及中央4点和12点的黄斑敏感度独立相关（p分别<0.0001和0.0002）。
RP患者黄斑血流减少与黄斑视觉敏感度降低有关。尽管因果关系仍有待阐明，但这些发现表明血管缺陷可能参与了RP如中心视力丧失的发病机制。
