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发育性视觉剥夺:对人锥体细胞驱动的视网膜功能的长期影响。

Developmental visual deprivation: long term effects on human cone driven retinal function.

作者信息

Esposito Veneruso Paolo, Ziccardi Lucia, Magli Giulia, Parisi Vincenzo, Falsini Benedetto, Magli Adriano

机构信息

GI.MA Eyecare Centre, Naples, Italy.

"G.B. Bietti" Foundation - IRCCS, Rome, Italy.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2017 Dec;255(12):2481-2486. doi: 10.1007/s00417-017-3780-0. Epub 2017 Aug 22.

Abstract

PURPOSE

To assess whether infantile visual deprivation induced by developmental cataract may influence the cone-driven retinal function in humans.

METHODS

A total of 14 patients with history of bilateral developmental cataract (DC), who had undergone uncomplicated cataract extraction surgery and intraocular lens implant, and 14 healthy subjects (HS) were enrolled. All patients underwent complete ophthalmological and orthoptic evaluations and best-corrected visual acuity measurement. Light-adapted full-field electroretinograms (ERG) and photopic negative responses (PhNR) were recorded to obtain a reliable measurement of the outer/inner retinal function and of the retinal ganglion cells' function, respectively.

RESULT

Mean values of light-adapted ERG a- and b-wave implicit times were slightly delayed when compared to HS values. Light-adapted ERG a-wave amplitude mean values showed borderline values (p = 0.001), whereas a-wave amplitude analysis at 5 ms, b-wave and PhNR amplitude mean values showed no significant differences when compared to control values. No significant correlations were found when age at surgery, time elapsed from surgery, duration of the visual deprivation, age at examination, age at first detection of the opacity, BCVA and electrophysiological parameters were plotted together. Coherently with morphological studies, the extremely light bioelectrical impairment of the cone pathway in our cohort of patients describes minimal functional abnormalities of a well-structured retina that is not completely mature.

CONCLUSIONS

Our present results, combined to those of our previous work on congenital cataracts, allow us to enhance the comprehension of functional developmental mechanisms of children's retinas and highlight the relevance of the timely treatment of lens opacities during infancy.

摘要

目的

评估发育性白内障导致的婴儿期视觉剥夺是否会影响人类视锥细胞驱动的视网膜功能。

方法

共纳入14例有双侧发育性白内障(DC)病史且接受了无并发症白内障摘除手术和人工晶状体植入的患者,以及14名健康受试者(HS)。所有患者均接受了全面的眼科和视光学评估以及最佳矫正视力测量。记录了明适应全视野视网膜电图(ERG)和明视负反应(PhNR),分别以可靠地测量视网膜外层/内层功能和视网膜神经节细胞功能。

结果

与HS的值相比,明适应ERG a波和b波的潜伏期平均值略有延迟。明适应ERG a波振幅平均值显示临界值(p = 0.001),而5毫秒时的a波振幅分析、b波和PhNR振幅平均值与对照值相比无显著差异。将手术年龄、手术时间、视觉剥夺持续时间、检查年龄、首次发现混浊的年龄、最佳矫正视力和电生理参数绘制在一起时,未发现显著相关性。与形态学研究一致,我们患者队列中视锥细胞通路极其轻微的生物电损伤描述了一个结构良好但未完全成熟的视网膜的最小功能异常。

结论

我们目前的结果与我们之前关于先天性白内障的研究结果相结合,使我们能够增强对儿童视网膜功能发育机制的理解,并突出婴儿期晶状体混浊及时治疗的相关性。

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