Sepah Y J, Sadiq M A, Hassan M, Hanout M, Soliman M, Agarwal A, Afridi R, Coupland S G, Nguyen Q D
Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 985540 Nebraska Medical Center, Omaha, NE 68198-5540, USA.
Curr Mol Med. 2015;15(6):578-86. doi: 10.2174/1566524015666150731104626.
To evaluate the thicknesses of individual retinal layers, and the correlation between structural changes and functional loss using spectral domain optical coherence tomography (SD-OCT) scans and electroretinograms (ERG), in eyes with autoimmune retinopathy (AIR).
SD-OCT raster scans of 12 eyes from 6 patients serologically diagnosed with AIR were evaluated. Retinal layers were segmented along a 5 mm horizontal scan passing through the fovea. Retinal layers analyzed include full retinal thickness (FRT), retinal pigment epithelium and Bruch's membrane complex (RPE+BM complex), photoreceptor layer (PRL), inner nuclear layer (INL), combined ganglion cell and inner plexiform layers (GCL+), nerve fiber layer (NFL), and combined GCL+ and NFL layers (GCL+/NFL). Changes in the thicknesses of the layers were assessed in 0.5 mm increments along the B-scan in the central, nasal, and temporal regions. These recorded values were compared to corresponding values of 51 eyes from 51 subjects with no known ocular pathology. Full-field ERGs were obtained at corresponding visits and were interpreted by a grader masked to the diagnoses and OCT findings.
The mean age of the patients was 59.5 years (range, 33-83), with 4 males (66.6%). Within the control population of 51 subjects, mean age was 51.5 years (range, 40-75), with 25 males (49%). Eyes with AIR showed a loss of retinal tissue compared to eyes with no known ocular pathology at the fovea. Specifically, the FRT, RPE+BM complex, and PRL exhibited thinning of statistically significance. ERG findings demonstrated a functional deficit which showed a good correlation with structural loss. Fifty (50) percent of eyes experienced central photoreceptor (rod and cone) dysfunction and 75% of eyes displayed peripheral photoreceptor (rod and cone) dysfunction.
Eyes with AIR show a loss of retinal tissue compared to eyes with no known ocular pathology. The greatest loss appears to occur in the RPE and PRL. ERG findings correlate strongly with the loss of tissue seen in these layers. Thus, therapeutic options may be targeted to preserve these regions of the retina.
利用光谱域光学相干断层扫描（SD - OCT）和视网膜电图（ERG）评估自身免疫性视网膜病变（AIR）患者的各视网膜层厚度，以及结构变化与功能丧失之间的相关性。
对6例血清学诊断为AIR的患者的12只眼睛进行SD - OCT光栅扫描评估。沿穿过黄斑中心凹的5毫米水平扫描分割视网膜层。分析的视网膜层包括视网膜全层厚度（FRT）、视网膜色素上皮和布鲁赫膜复合体（RPE + BM复合体）、光感受器层（PRL）、内核层（INL）、神经节细胞和内网状层联合层（GCL +）、神经纤维层（NFL）以及GCL +和NFL联合层（GCL + / NFL）。沿B扫描在中心、鼻侧和颞侧区域以0.5毫米的增量评估各层厚度的变化。将这些记录值与51名无已知眼部病变受试者的51只眼睛的相应值进行比较。在相应就诊时获取全视野ERG，并由对诊断和OCT结果不知情的分级人员进行解读。
患者的平均年龄为59.5岁（范围33 - 83岁），男性4例（66.6%）。在51名受试者的对照组中，平均年龄为51.5岁（范围40 - 75岁），男性25例（49%）。与无已知眼部病变的眼睛相比，AIR患者的眼睛在黄斑中心凹处出现视网膜组织缺失。具体而言，FRT、RPE + BM复合体和PRL表现出具有统计学意义的变薄。ERG结果显示存在功能缺陷，且与结构丧失具有良好的相关性。50%的眼睛出现中心光感受器（视杆和视锥）功能障碍，75%的眼睛出现周边光感受器（视杆和视锥）功能障碍。
与无已知眼部病变的眼睛相比，AIR患者的眼睛出现视网膜组织缺失。最大的组织缺失似乎发生在RPE和PRL。ERG结果与这些层中所见的组织丧失密切相关。因此，治疗方案可能旨在保护视网膜的这些区域。
