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脉络膜血色素沉着症伴巩膜凹陷和隧道的患者的长期随访:一项新的观察。

LONG-TERM FOLLOW-UP OF PATIENTS WITH CHOROIDEREMIA WITH SCLERAL PITS AND TUNNELS AS A NOVEL OBSERVATION.

机构信息

Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands.

Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Retina. 2018 Sep;38(9):1713-1724. doi: 10.1097/IAE.0000000000001844.

Abstract

PURPOSE

To evaluate the long-term clinical course and visual outcome of patients with choroideremia.

METHODS

Clinical examination, a social questionnaire, and medical records review of 21 patients with choroideremia from 14 families.

RESULTS

The mean follow-up time was 25.2 years (SD: 13.3; range 2-57 years). The mean age at symptom onset was 15.1 years (SD: 10.1; range 5-40 years). Best-corrected visual acuity was stable until the age of 35 (P = 0.96), but declined significantly faster after the age of 35 (11%/year, P = 0.001), with a high variability between individual patients. The mean age at which patients discontinued working was 48.1 years (SD: 11.7, range 25-65 years). The reason for work discontinuation was vision related in 60% of cases. Most patients (70%) reported visual field constriction as the most debilitating symptom. The authors report scleral pits and tunnels as a novel finding visible on spectral domain optical coherence tomography and ophthalmoscopy.

CONCLUSION

Choroideremia is a severely debilitating disease showing a rapid decline of visual acuity generally after the age of 35, but a more gradual decline for other abnormalities.

摘要

目的

评估脉络膜视网膜变性患者的长期临床病程和视觉预后。

方法

对 14 个家系的 21 名脉络膜视网膜变性患者进行临床检查、社会问卷调查和病历回顾。

结果

平均随访时间为 25.2 年(标准差:13.3;范围 2-57 年)。症状起始的平均年龄为 15.1 岁(标准差:10.1;范围 5-40 岁)。最佳矫正视力在 35 岁之前保持稳定(P = 0.96),但在 35 岁之后下降速度显著加快(每年 11%,P = 0.001),个体间差异较大。患者停止工作的平均年龄为 48.1 岁(标准差:11.7,范围 25-65 岁)。60%的患者因视力相关原因停止工作。大多数患者(70%)报告视野缩小是最使人衰弱的症状。作者报告了巩膜陷窝和隧道,这是在频域光相干断层扫描和眼底镜下可见的一种新发现。

结论

脉络膜视网膜变性是一种严重致残疾病,通常在 35 岁后视力迅速下降,但其他异常的下降速度较为缓慢。

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