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白塞病缓解期黄斑视网膜内层增厚和外层视网膜损伤与视力相关。

Macular Inner Retinal Layer Thickening and Outer Retinal Layer Damage Correlate With Visual Acuity During Remission in Behcet's Disease.

作者信息

Cheng Dan, Wang Yuqin, Huang Shenghai, Wu Qiuyan, Chen Qi, Shen Meixiao, Lu Fan

机构信息

School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5470-5478. doi: 10.1167/iovs.16-19568.

DOI:10.1167/iovs.16-19568
PMID:27760261
Abstract

PURPOSE

To identify macular intraretinal layer changes of patients in remission from Behcet's disease (BD) of short and long duration and evaluate the associations with visual acuity (VA).

METHODS

Thirty-two eyes from 26 BD patients were enrolled, including 16 eyes with a duration less than 3 years (0.5-2.5 years; BD1) and 16 eyes of longer duration (3-12 years; BD2). Their intraretinal layer thicknesses and integrity of ellipsoid zone (EZ) and interdigitation zone (IZ) were evaluated by spectral-domain optical coherence tomography (SD-OCT). Associations between VA and retinal structural changes were analyzed.

RESULTS

Compared to controls, the inner retina was significantly thicker in BD groups, especially the nerve fiber layer (NFL). The outer retinal layer (ORL) was thicker in BD1 in the central and temporal regions and thinner in BD2 compared to controls in all regions. In BD2, there were more eyes with disruption of the EZ and IZ. Worsening VA was correlated with thickening of the NFL and inner nuclear layer (INL), thinning of the ORL, and greater disruption of the EZ and IZ. Multiple linear regression analysis revealed EZ disruption, nasal ORL, inferior NFL, and temporal and nasal INLs were independent predictors of best-corrected (BCVA).

CONCLUSIONS

Behcet's disease patients in remission had significant changes in the inner and outer retinal structures, associated with worse VA. Thickness and integrity of the intraretinal layers by SD-OCT and segmentation might be useful predictors for the degree of VA damage in BD remission.

摘要

目的

识别短期和长期缓解期白塞病(BD)患者的黄斑视网膜内层变化,并评估其与视力(VA)的相关性。

方法

纳入26例BD患者的32只眼,其中病程小于3年(0.5 - 2.5年;BD1组)的有16只眼,病程较长(3 - 12年;BD2组)的有16只眼。通过光谱域光学相干断层扫描(SD - OCT)评估其视网膜内层厚度以及椭圆体带(EZ)和指状交叉带(IZ)的完整性。分析VA与视网膜结构变化之间的相关性。

结果

与对照组相比,BD组的视网膜内层明显增厚,尤其是神经纤维层(NFL)。BD1组在中央和颞侧区域的视网膜外层(ORL)较厚,而BD2组在所有区域的ORL均比对照组薄。在BD2组中,有更多眼睛的EZ和IZ遭到破坏。视力下降与NFL和内核层(INL)增厚、ORL变薄以及EZ和IZ的更大程度破坏相关。多元线性回归分析显示,EZ破坏、鼻侧ORL、下方NFL以及颞侧和鼻侧INL是最佳矫正视力(BCVA)的独立预测因素。

结论

缓解期白塞病患者的视网膜内外层结构有显著变化,且与较差的视力相关。通过SD - OCT和分层分析视网膜内层的厚度和完整性,可能是BD缓解期VA损害程度的有用预测指标。

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