Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
Acta Ophthalmol. 2019 Nov;97(7):e1013-e1018. doi: 10.1111/aos.14097. Epub 2019 Apr 9.
Patients with proliferative diabetic retinopathy (PDR) treated with panretinal photocoagulation (PRP) can have abnormal visual functioning that may be missed by Snellen visual acuity alone. We investigated reading deficits in patients treated with PRP for PDR using the Minnesota reading (MNREAD) test.
Thirty patients treated with PRP and 15 controls underwent best-corrected visual acuity (BCVA), the MNREAD, frequency doubling perimetry (FDP), and fundus photography. Panretinal photocoagulation (PRP)-treated subjects were compared to controls on MNREAD results by two-sample t-tests and Wilcoxon tests and Pearson correlations were used to assess the association between performance on MNREAD and other central visual function tests within PRP subjects.
Panretinal photocoagulation (PRP)-treated patients had reduced MNREAD acuity (p < 0.0001) and increased critical print size (p = 0.01) compared to controls but not a significantly reduced maximum reading speed (p = 0.06). Logmar MNREAD acuity was strongly positive correlated with logMAR BCVA (r = 0.58, p = 0.0098) and strongly negatively correlated with FDP foveal threshold (r = -0.63, p = 0.0030). Maximum reading speed was positively correlated with FDP foveal threshold (r = 0.57, p = 0.0143) and FDP mean deviation (r = 0.51, p = 0.0432). Visual acuity did not correlate with the sensitivities on the FDP.
The MNREAD test reveals that PRP reduces reading ability and other aspects of macular function, and thus provides new understanding of how vision-related quality of life is impaired. These findings may lead to improved means to evaluate and enhance vision following treatment for PDR.
接受全视网膜光凝 (PRP) 治疗的增殖性糖尿病性视网膜病变 (PDR) 患者可能存在视力异常,而单纯的 Snellen 视力检查可能会忽略这些异常。我们使用明尼苏达州阅读测试 (MNREAD) 评估了接受 PRP 治疗的 PDR 患者的阅读障碍。
对 30 名接受 PRP 治疗的患者和 15 名对照者进行最佳矫正视力 (BCVA)、MNREAD、频域光相干断层扫描 (FDP) 和眼底照相检查。采用两样本 t 检验和 Wilcoxon 检验比较 PRP 治疗组与对照组的 MNREAD 结果,Pearson 相关分析用于评估 PRP 患者 MNREAD 与其他中心视觉功能测试之间的相关性。
与对照组相比,接受 PRP 治疗的患者 MNREAD 视力(p < 0.0001)和临界印刷尺寸(p = 0.01)降低,但最大阅读速度无明显降低(p = 0.06)。LogMAR MNREAD 视力与 LogMAR BCVA 呈正相关(r = 0.58,p = 0.0098),与 FDP 黄斑中心凹阈值呈负相关(r = -0.63,p = 0.0030)。最大阅读速度与 FDP 黄斑中心凹阈值(r = 0.57,p = 0.0143)和 FDP 平均偏差(r = 0.51,p = 0.0432)呈正相关。视力与 FDP 敏感度无相关性。
MNREAD 测试显示 PRP 降低了阅读能力和其他黄斑功能,从而提供了对视力相关生活质量受损方式的新认识。这些发现可能会导致更好的评估和增强 PDR 治疗后视力的方法。