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视网膜色素变性患者的异常立体视觉和视网膜敏感性降低。

Abnormal stereopsis and reduced retinal sensitivity in patients with retinitis pigmentosa.

作者信息

Vingolo Enzo Maria, Limoli Paolo Giuseppe, Steigerwalt Robert Davis Jr, Carlesimo Sandra Cinzia, Salvatore Serena

机构信息

Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p. le A. Moro 5, 00185, Rome, Italy.

Low Vision Research Centre of Milan, p.za Sempione 3, 20145, Milan, Italy.

出版信息

Int Ophthalmol. 2020 Jan;40(1):179-184. doi: 10.1007/s10792-019-01166-w. Epub 2019 Aug 28.

Abstract

PURPOSE

The aim of the study was to evaluate retinal sensitivity and stereoacuity (SA) in retinitis pigmentosa (RP) patients.

METHODS

Twenty-six patients with RP were examined, mean age 36.4 ± 7.21 (SD) years old and best corrected visual acuity better than 0.15 logMAR. The control group (CG) included 25 healthy subjects matching the RP group by age and sex. Every patient and healthy control underwent a complete ophthalmologic examination: Titmus, Lang, TNO stereotests and microperimetry (MP-1) (Nidek Technologies). Results were subjected to factor analysis using Varimax rotation, and p values < 0.05 were considered statistically significant.

RESULTS

With the Titmus stereotest, the mean SA was 136.52 ± 26.5 (SD) arcsec in the RP group and 67.2 ± 11.5 (SD) in CG; Lang SA was 391.39 ± 53.72 (SD) in RP group and 1150 ± 33.4 (SD) in CG; and TNO SA was 69.3 ± 14.39 (SD) in the RP group and 15.97 ± 3.7 (SD) in CG. Factor analysis showed significant correlation between visual acuity and SA (p = 0.0001) in RP group. MP-1 demonstrated that in RP patients, inter-ocular difference in retinal sensitivity and fixation stability was related to anomalous stereopsis (p values < 0.05).

CONCLUSION

Progressive RP degeneration in the cone system could determine a significant impairment in the binocular vision due to anomalous inter-ocular retinal sensitivity and incomplete Panum's area utilization, causing an incongruent retinal localization. These findings suggest a possible reason why RP patients with a central retinal involvement, even if minimal, perceive a damaged stereoscopic perception that produces a severe disability.

摘要

目的

本研究旨在评估视网膜色素变性(RP)患者的视网膜敏感度和立体视锐度(SA)。

方法

对26例RP患者进行检查,平均年龄36.4±7.21(标准差)岁,最佳矫正视力优于0.15 logMAR。对照组(CG)包括25名年龄和性别与RP组匹配的健康受试者。每位患者和健康对照均接受了全面的眼科检查:Titmus、Lang、TNO立体视测试和微视野计(MP-1)(尼德克科技公司)。结果采用方差最大化旋转进行因子分析,p值<0.05被认为具有统计学意义。

结果

在Titmus立体视测试中,RP组的平均SA为136.52±26.5(标准差)角秒,CG组为67.2±11.5(标准差);Lang SA在RP组为391.39±53.72(标准差),CG组为1150±33.4(标准差);TNO SA在RP组为69.3±14.39(标准差),CG组为15.97±3.7(标准差)。因子分析显示RP组中视力与SA之间存在显著相关性(p = 0.0001)。MP-1表明,在RP患者中,双眼视网膜敏感度和注视稳定性的差异与异常立体视有关(p值<0.05)。

结论

锥系统中进行性RP变性可能由于双眼视网膜敏感度异常和潘诺氏区利用不完全而导致双眼视觉显著受损,从而引起视网膜定位不一致。这些发现提示了一个可能的原因,即即使是轻度的视网膜中央受累的RP患者,也会感觉到立体视觉受损,从而导致严重的功能障碍。

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