Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan.
Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):1134-1143. doi: 10.1167/iovs.17-23050.
To investigate the relationships between foveal blood flow as measured by laser speckle flowgraphy (LSFG), the retinal-choroidal structure in enhanced depth imaging-optical coherence tomography (EDI-OCT), and central visual function in patients with retinitis pigmentosa (RP).
We studied 52 consecutive typical RP patients ≤50 years old and 21 age- and sex-matched controls. The mean blur rate (MBR), which represents the blood flow volume, was calculated in a 2.4-mm2 area centered on the fovea by LSFG. Subfoveal horizontal EDI-OCT images were recorded, and the choroidal area, choroidal hyporeflective area, and choroidal hyperreflective area were analyzed in the central 2.4-mm-wide region. The central foveal thickness (CFT), subfoveal choroidal thickness (SCT), and ellipsoid zone (EZ) width were also measured. Visual acuity (VA) and retinal sensitivity (Humphrey 10-2 program) were measured in the RP patients.
The MBR, choroidal area, hyporeflective area, hyperreflective area, and SCT were significantly decreased in the RP patients (all P < 0.001, versus controls). Spearman's rank testing demonstrated no significant correlation between the MBR and the choroidal structural parameters in the RP patients. Decreased MBR was significantly associated with reductions in VA, retinal sensitivity, CFT, and EZ width (all P < 0.05). The choroidal structural parameters did not correlate with central visual function, and the choroidal area, hyperreflective area, and SCT were inversely associated with CFT (all P < 0.05).
These results demonstrated the divergence between the choroidal structure and blood function, and suggest that decreased choroidal flow, rather than the structural alteration, is closely associated with foveal degeneration in RP.
利用激光散斑血流成像（LSFG）测量黄斑区血流，结合增强深度成像光相干断层扫描（EDI-OCT）的视网膜脉络膜结构，探讨其与色素性视网膜炎（RP）患者中心视力的关系。
本研究纳入了 52 例≤50 岁的典型 RP 患者和 21 例年龄、性别匹配的对照者。通过 LSFG 在黄斑中心 2.4mm2 区域计算平均模糊率（MBR），代表血流容积。记录黄斑中心 2.4mm 宽区域的 EDI-OCT 图像，分析脉络膜面积、脉络膜低反射区和脉络膜高反射区。还测量中心凹视网膜厚度（CFT）、黄斑中心下脉络膜厚度（SCT）和椭圆体带（EZ）宽度。RP 患者测量视力（VA）和视网膜敏感度（Humphrey 10-2 程序）。
与对照组相比，RP 患者的 MBR、脉络膜面积、低反射区面积、高反射区面积和 SCT 均显著降低（均 P < 0.001）。Spearman 秩相关检验表明，RP 患者的 MBR 与脉络膜结构参数之间无显著相关性。MBR 降低与 VA、视网膜敏感度、CFT 和 EZ 宽度降低显著相关（均 P < 0.05）。脉络膜结构参数与中心视力无相关性，脉络膜面积、高反射区面积和 SCT 与 CFT 呈负相关（均 P < 0.05）。
这些结果表明脉络膜结构与血流功能存在差异，提示脉络膜血流减少而不是结构改变与 RP 患者黄斑区变性密切相关。
