Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Dr. Nasser Al-Rashid Research Chair in Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Br J Ophthalmol. 2019 Dec;103(12):1695-1699. doi: 10.1136/bjophthalmol-2018-313719. Epub 2019 Feb 23.
To discover whether retinal vessel oxygen metabolism is affected in uveitis associated with Vogt-Koyanagi-Harada (VKH) disease.
41 patients with VKH disease (82 eyes) and 12 healthy subjects (24 eyes) matched in age and gender were prospectively evaluated. Retinal oxygen saturation and vessel calibre were measured with a non-invasive spectrophotometric retinal oximeter (Oxymap T1).
In healthy controls, mean arteriolar oxygen saturation (%) was 93.8±5.9 and venular saturation was 60.1±5.8. In acute VKH uveitic phase associated with exudative retinal detachment (n=12), arteriolar and venular oxygen saturation values were 104.7±7.8 and 67.9±7.7, respectively, and both are significantly higher than the healthy group (p<0.001; p=0.001, respectively). In patients with VKH disease who recovered after immunosuppressive therapy and restored normal anatomy without 'sunset glow fundus' (n=13), oximetry values were 96.4±9.6 and 61.6±7.5, respectively, similar to healthy controls. In patients with 'sunset glow fundus' and chorioretinal atrophy (n=16), saturation levels were 88.6±7.8 and 50.0±13.1, respectively, significantly lower than healthy controls (p=0.02; p=0.003, respectively). These patients also had significantly smaller diameter of retinal arterioles and venules compared with controls (p=0.035; p=0.001, respectively).
Retinal oxygen metabolism is altered in uveitis associated with VKH disease. Oxygen saturation profile is abnormal in acute uveitic phase of the disease and returns to normal in those who recover with normal fundus appearance, but not in eyes that suffer permanent anatomical damage with 'sunset glow fundus' and chorioretinal atrophy. Retinal oximetry may be of value in evaluating vascular and metabolic aspects of posterior uveitis.
探讨葡萄膜炎相关性 Vogt-小柳原田综合征（VKH）疾病是否会影响视网膜血管氧代谢。
前瞻性评估 41 例 VKH 疾病患者（82 只眼）和 12 名年龄和性别相匹配的健康受试者（24 只眼）。使用非侵入性光谱视网膜血氧计（Oxymap T1）测量视网膜氧饱和度和血管直径。
在健康对照组中，平均动脉血氧饱和度（%）为 93.8±5.9，静脉血氧饱和度为 60.1±5.8。在伴有渗出性视网膜脱离的急性 VKH 葡萄膜炎活动期（n=12），动、静脉氧饱和度值分别为 104.7±7.8 和 67.9±7.7，均显著高于健康组（p<0.001；p=0.001）。经免疫抑制治疗后恢复正常解剖结构且无“落日眼”（n=13）的 VKH 疾病患者，血氧测量值分别为 96.4±9.6 和 61.6±7.5，与健康对照组相似。“落日眼”和脉络膜视网膜萎缩（n=16）患者的饱和度水平分别为 88.6±7.8 和 50.0±13.1，与健康对照组相比显著降低（p=0.02；p=0.003）。与对照组相比，这些患者的视网膜小动脉和小静脉直径也明显更小（p=0.035；p=0.001）。
葡萄膜炎相关性 VKH 疾病会改变视网膜的氧代谢。疾病的急性葡萄膜炎期氧饱和度谱异常，在眼底外观恢复正常的患者中恢复正常，但在伴有“落日眼”和脉络膜视网膜萎缩的永久性解剖结构损害的患者中则不会。视网膜血氧测量法可能有助于评估后部葡萄膜炎的血管和代谢方面。
