Bae Kunho, Cho Kyuyeon, Kang Se Woong, Kim Sang Jin, Kim Jong Min
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
PLoS One. 2017 Jan 23;12(1):e0170526. doi: 10.1371/journal.pone.0170526. eCollection 2017.
To explore the pathogenesis of peripheral reticular pigmentary degeneration (PRPD) and its clinical significance.
This cross-sectional, observational study (conducted between January 2010 and May 2015) enrolled 441 eyes of 229 subjects, including 35 eyes with PRPD and 406 eyes without PRPD, which was identified by ultra-wide-field fluorescein angiography (UWFA). The distribution and angiographic circulation time of PRPD were assessed by UWFA. The frequencies of systemic and ophthalmologic comorbidities were compared between groups. Univariate and multivariate generalized estimation equation methods were used to determine the risk factors for PRPD.
The patients with PRPD had a mean age of 75.7 ± 8.5 years (range, 59-93 years), whereas the patients without PRPD had a mean age of 60.1 ± 14.9 years (range, 9-92 years). All eyes with PRPD manifested the lesion in the superior nasal periphery with or without circumferential extension. Among those, only 16 eyes (45.7%) in the PRPD group showed distinctive features in the same location on fundus photographs. There was significant choroidal filling delay in the PRPD group when compared with the control group (1.42±1.22 vs. -0.02±1.05 seconds, P < 0.001). Multivariate regression analysis revealed that older age (P < 0.001), stroke (P = 0.018), ischemic optic neuropathy (P < 0.001), and age-related macular degeneration (P = 0.022) were significantly associated with PRPD.
UWFA may enhance the diagnostic sensitivity of PRPD. Choroidal vascular insufficiency with compromised systemic circulation in the elderly was related to the manifestation of PRPD. These results help to better understand the pathophysiology of PRPD. Co-existence of systemic and ophthalmic circulatory disorders should be considered in patients with PRPD.
探讨周边网状色素变性（PRPD）的发病机制及其临床意义。
本横断面观察性研究（于2010年1月至2015年5月进行）纳入了229名受试者的441只眼，其中包括35只患有PRPD的眼和406只未患PRPD的眼，通过超广角荧光血管造影（UWFA）进行识别。通过UWFA评估PRPD的分布和血管造影循环时间。比较两组全身和眼科合并症的发生率。采用单因素和多因素广义估计方程方法确定PRPD的危险因素。
患有PRPD的患者平均年龄为75.7±8.5岁（范围59 - 93岁），而未患PRPD的患者平均年龄为60.1±14.9岁（范围9 - 92岁）。所有患有PRPD的眼均在上鼻周边出现病变，有或无圆周延伸。其中，PRPD组中只有16只眼（45.7%）在眼底照片的同一位置显示出独特特征。与对照组相比，PRPD组存在明显的脉络膜充盈延迟（1.42±1.22对 - 0.02±1.05秒，P < 0.001）。多因素回归分析显示，年龄较大（P < 0.001）、中风（P = 0.018）、缺血性视神经病变（P < 0.001）和年龄相关性黄斑变性（P = 0.022）与PRPD显著相关。
UWFA可能提高PRPD的诊断敏感性。老年人脉络膜血管功能不全伴全身循环受损与PRPD的表现有关。这些结果有助于更好地理解PRPD的病理生理学。PRPD患者应考虑全身和眼科循环障碍并存的情况。
