微视野检查法——评估黄斑疾病视网膜敏感度的新工具
Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases.
作者信息
Laishram Memota, Srikanth Krishnagopal, Rajalakshmi A R, Nagarajan Swathi, Ezhumalai G
机构信息
Resident, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
Professor and Head, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
出版信息
J Clin Diagn Res. 2017 Jul;11(7):NC08-NC11. doi: 10.7860/JCDR/2017/25799.10213. Epub 2017 Jul 1.
INTRODUCTION
Macular disease is the leading cause of low vision in the Western world. Drusen and pigmentary irregularities are common among the rural Northern Indian population. The disease process leads to loss of central vision, metamorphopsia, macropsia or micropsia and colour vision defect.
AIM
To study the retinal sensitivity changes in macular diseases using microperimetry.
MATERIALS AND METHODS
It was an observational study, conducted in the Department of Ophthalmology at a rural tertiary care hospital. This study was started from December 2014 until June 2016, in all patients with macular disease above the age of 20 years attending the outpatient department. Microperimetry was done for 84 eyes of 52 patients with macular disease. Mean retinal Sensitivity (MS) and fixation stability was evaluated. The statistical analysis of mean retinal sensitivity, central 2° and 4° fixation was done by calculating the mean and standard deviation using 95% confidence interval.
RESULTS
The range of age was between 20-81 years. Majority were 32 males (62%) and 20 females (38%). Out of the 84 eyes studied, majority of the macular disease were Age-Related Macular Degeneration (AMD) (50%). Rest 50% were other macular diseases. The mean retinal sensitivity (dB) shown by microperimetry was 10.83 in AMD, 9.12 in Cystoid Macular Oedema (CME), 10.34 in Epiretinal Membrane (ERM), 10.74 in Pigment Epithelial Detachment (PED), 8.96 in Central Serous Chorioretinopathy (CSCR), 6.43 in macular dystrophy, 7.15 in Lamellar Hole (LMH), 9.8 in Pseudomacular Hole (PMH), 3 in geographic atrophy, 11.1 in macular telangiectasia, 5.6 in Berlin oedema, 12.3 in macular scar and 15.2 in haemorrhage in macula. The study showed 64% of the eyes had stable 2° central fixation, 35% had relatively unstable fixation and 1% had unstable fixation. No significant correlation between retinal sensitivity and retinal thickness in AMD was found.
CONCLUSION
This study shows that microperimetry can be a useful tool for objective evaluation of macular function and progression of the disease.
引言
黄斑疾病是西方世界视力低下的主要原因。玻璃膜疣和色素异常在印度北部农村人口中很常见。该疾病进程会导致中心视力丧失、视物变形、视物显大症或视物显小症以及色觉缺陷。
目的
使用微视野计研究黄斑疾病患者视网膜敏感度的变化。
材料与方法
这是一项在农村三级护理医院眼科进行的观察性研究。本研究于2014年12月至2016年6月开展，纳入所有年龄在20岁以上、到门诊就诊的黄斑疾病患者。对52例黄斑疾病患者的84只眼进行了微视野计检查。评估了平均视网膜敏感度（MS）和注视稳定性。通过计算均值和标准差并使用95%置信区间，对平均视网膜敏感度、中心2°和4°注视进行了统计分析。
结果
年龄范围在20 - 81岁之间。多数为男性32例（62%），女性20例（38%）。在研究的84只眼中，多数黄斑疾病为年龄相关性黄斑变性（AMD）（50%）。其余50%为其他黄斑疾病。微视野计显示的平均视网膜敏感度（dB）在AMD中为10.83，在黄斑囊样水肿（CME）中为9.12，在视网膜前膜（ERM）中为10.34，在色素上皮脱离（PED）中为10.74，在中心性浆液性脉络膜视网膜病变（CSCR）中为8.96，在黄斑营养不良中为6.43，在板层裂孔（LMH）中为7.15，在假性黄斑裂孔（PMH）中为9.8，在地图样萎缩中为3，在黄斑毛细血管扩张中为11.1，在柏林水肿中为5.6，在黄斑瘢痕中为12.3，在黄斑出血中为15.2。研究显示64%的眼中心2°注视稳定，35%的眼注视相对不稳定，1%的眼注视不稳定。在AMD中未发现视网膜敏感度与视网膜厚度之间存在显著相关性。
结论
本研究表明，微视野计可作为客观评估黄斑功能和疾病进展的有用工具。
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