Kominami Taro, Ueno Shinji, Kominami Azusa, Nakanishi Ayami, Yasuda Shunsuke, Piao Chang-Hua, Okado Satoshi, Terasaki Hiroko
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5122-5128. doi: 10.1167/iovs.17-22040.
Our earlier study showed that the width of the intact ellipsoid zone (EZ) of the photoreceptors was significantly but weakly correlated with the amplitudes of the focal macular ERGs (FMERGs). The aim of this study was to determine a microstructure of the photoreceptors in the spectral-domain optical coherence tomographic (SD-OCT) images that was more strongly correlated with the FMERG parameters in eyes with retinitis pigmentosa (RP).
This was a retrospective, observational study. The medical records of 65 patients with RP were reviewed. FMERGs were elicited by a 15-degree stimulus spot. The width of the EZ and the outer segment (OS) area surrounded by EZ and retinal pigment epithelium in the SD-OCT images within 15 degrees of the fovea were evaluated. Spearman correlation tests and multiple stepwise regression analyses were performed.
There was a strong correlation between the amplitudes of FMERGs and the EZ width (r = 0.68 for a-wave amplitude; r = 0.64 for b-wave amplitude), and also between the amplitudes of the FMERGs and the OS area (r = 0.69 for a-wave amplitude; r = 0.67 for b-wave amplitude). However, some patients had long EZ widths but had severely reduced FMERGs. Multiple stepwise regression analyses showed that the OS area was the only significant independent predictor of the amplitudes of FMERGs (P < 0.001).
The OS area might be a better morphological structure to use to predict the physiological function of the macula.
我们早期的研究表明，光感受器完整椭圆体区（EZ）的宽度与黄斑中心凹局部视网膜电图（FMERG）的振幅显著但弱相关。本研究的目的是在视网膜色素变性（RP）患者的光谱域光学相干断层扫描（SD-OCT）图像中确定一种与FMERG参数更强相关的光感受器微观结构。
这是一项回顾性观察研究。回顾了65例RP患者的病历。通过15度刺激光斑诱发FMERG。评估黄斑中心凹15度范围内SD-OCT图像中EZ的宽度以及EZ和视网膜色素上皮包围的外段（OS）面积。进行了Spearman相关性检验和多元逐步回归分析。
FMERG的振幅与EZ宽度之间存在强相关性（a波振幅r = 0.68；b波振幅r = 0.64），FMERG的振幅与OS面积之间也存在强相关性（a波振幅r = 0.69；b波振幅r = 0.67）。然而，一些患者的EZ宽度较长，但FMERG严重降低。多元逐步回归分析表明，OS面积是FMERG振幅的唯一显著独立预测因子（P < 0.001）。
OS面积可能是用于预测黄斑生理功能的更好形态结构。
