Smirnov Vasily, Drumare Isabelle, Bouacha Ikram, Puech Bernard, Defoort-Dhellemmes Sabine
Exploration of Visual Function and Neuro-Ophthalmology Department, Lille University Hospital, Rue Emilie Laine, 59037, Lille Cedex, France.
Doc Ophthalmol. 2015 Oct;131(2):149-58. doi: 10.1007/s10633-015-9508-8. Epub 2015 Jul 3.
Oligocone trichromacy (OT) is an uncommon cone dysfunction disorder, the mechanism of which remains poorly understood. OT has been thought to be non-progressive, but its long-term visual outcome has been seldom reported in the literature. Our aim was to present two OT patients followed at our institution over 18 years.
Complete ocular examination, color vision, visual fields, and full-field electroretinography (ERG) were performed at initial presentation and follow-up. Spectral-domain optical coherence tomography (OCT) was performed during follow-up when available at our institution.
Initial ocular examination showed satisfactory visual acuities with normal fundus examination and near-to-normal color vision. However, computerized perimetry demonstrated a ring-shaped scotoma around fixation, and ERG showed a profound cone dysfunction. The discrepancy between preserved color vision and profound cone dysfunction leads to the diagnosis of OT. Subsequent follow-ups over 18 years showed subtle degradation of visual acuities along with progression of the myopia in both patients and slight worsening of color vision in one patient. Initial OCT revealed a focal interruption of the ellipsoid line along with decreased thickness of the perifoveal macula. Subsequent OCT imaging performed 2 years later did not show any macular changes.
Although OT is known to be a non-progressive cone dysfunction, our results suggest that subtle degradation of the visual function might happen over time.
少锥三色性(OT)是一种罕见的视锥细胞功能障碍性疾病,其发病机制仍知之甚少。OT一直被认为是非进行性的,但文献中很少报道其长期视觉预后情况。我们的目的是介绍在我们机构随访了18年的两名OT患者。
在初次就诊和随访时进行了全面的眼部检查、色觉、视野和全视野视网膜电图(ERG)检查。在随访期间,若我们机构有条件,则进行了光谱域光学相干断层扫描(OCT)检查。
初次眼部检查显示视力良好,眼底检查正常,色觉接近正常。然而,电脑视野检查显示在注视点周围有环形暗点,ERG显示严重的视锥细胞功能障碍。保留的色觉与严重的视锥细胞功能障碍之间的差异导致了OT的诊断。随后18年的随访显示,两名患者的视力均有轻微下降,近视程度加重,其中一名患者的色觉略有恶化。初次OCT显示椭圆体线有局灶性中断,黄斑中心凹周围厚度变薄。两年后进行的后续OCT成像未显示黄斑有任何变化。
虽然已知OT是一种非进行性视锥细胞功能障碍,但我们的结果表明,随着时间的推移,视觉功能可能会出现轻微下降。