Nittala Muneeswar G, Velaga Swetha Bindu, Hariri Amir, Pfau Maximilian, Birch David G, Haines Jonathan, Pericak-Vance Margaret A, Stambolian Dwight, Sadda SriniVas R
Ophthalmic Surg Lasers Imaging Retina. 2019 Sep 1;50(9):e236-e241. doi: 10.3928/23258160-20190905-15.
BACKGROUND AND OBJECTIVES: To evaluate retinal sensitivity (RS) by mesopic and scotopic microperimetry (MP-1S) in an elderly Amish population with age-related macular degeneration (AMD). PATIENTS AND METHODS: Mesopic and scotopic microperimetric testing was performed in 148 eyes of 77 elderly Amish subjects (age > 50 years) from Pennsylvania using a retinal function analyzer. Scotopic testing was performed using a 2.0 log unit neutral density filter following 30 minutes of dark adaptation. All subjects underwent complete ophthalmic examinations, including spectral-domain optical coherence tomography, fundus autofluorescence, infrared reflectance imaging, and flash color fundus photography. Certified graders at Doheny Image Reading Center identified subjects with evidence of AMD as defined by the Beckman classification and quantified drusen volume. RS in subjects with and without AMD was compared. Correlations between RS and drusen burden were analyzed. Ten eyes with incomplete MP-1S exams were excluded from the final analysis. RESULTS: Among the 138 eyes from 77 subjects included in the final analysis, 42 eyes from 29 subjects had evidence of early or intermediate AMD. The mean age of subjects with AMD was 69.65 years ± 13.81 years versus 63.04 years ± 12.69 years in those without AMD (P = .06). Mesopic RS was 18.8 dB ± 2.1 dB in subjects with AMD and 19.6 dB ± 1.4 dB in those without AMD (P = .07). Scotopic RS was significantly lower (P = .04) in subjects with AMD (15.9 dB ± 2.9 dB) compared with those without AMD (17.3 dB ± 2.4 dB). There was no relationship between mesopic RS and either drusen area (r = -0.06; P = .32) or drusen volume (r = -0.08; P = .30). There was a trend for an association between scotopic RS and both drusen area (r = -0.39; P = .24) and drusen volume (r = -0.36; P = .30). CONCLUSIONS: In an elderly Amish population, eyes with early or intermediate AMD show a greater reduction in scotopic RS than mesopic RS, suggesting that rod function is more severely affected than cone function. Drusen area and volume measurements better correlated with scotopic RS. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e236-e241.].
背景与目的：通过中视和暗视微视野计（MP-1S）评估患有年龄相关性黄斑变性（AMD）的老年阿米什人群的视网膜敏感度（RS）。 患者与方法：使用视网膜功能分析仪对来自宾夕法尼亚州的77名年龄大于50岁的老年阿米什受试者的148只眼睛进行中视和暗视微视野测试。在暗适应30分钟后，使用2.0对数单位中性密度滤光片进行暗视测试。所有受试者均接受了全面的眼科检查，包括光谱域光学相干断层扫描、眼底自发荧光、红外反射成像和闪光彩色眼底照相。多希尼图像阅读中心的认证分级人员根据贝克曼分类法确定有AMD证据的受试者，并对玻璃膜疣体积进行量化。比较有和没有AMD的受试者的RS。分析RS与玻璃膜疣负荷之间的相关性。最终分析排除了10只MP-1S检查不完整的眼睛。 结果：在最终分析纳入的77名受试者的138只眼中，29名受试者的42只眼有早期或中期AMD的证据。有AMD的受试者的平均年龄为69.65岁±13.81岁，而没有AMD的受试者为63.04岁±12.69岁（P = 0.06）。有AMD的受试者的中视RS为18.8 dB±2.1 dB，没有AMD的受试者为19.6 dB±1.4 dB（P = 0.07）。有AMD的受试者的暗视RS（15.9 dB±2.9 dB）明显低于没有AMD的受试者（17.3 dB±2.4 dB）（P = 0.04）。中视RS与玻璃膜疣面积（r = -0.06；P = 0.32）或玻璃膜疣体积（r = -0.08；P = 0.30）之间均无相关性。暗视RS与玻璃膜疣面积（r = -0.39；P = 0.24）和玻璃膜疣体积（r = -0.36；P = 0.30）之间均有相关趋势。 结论：在老年阿米什人群中，患有早期或中期AMD的眼睛暗视RS的降低幅度大于中视RS，这表明视杆细胞功能比视锥细胞功能受到的影响更严重。玻璃膜疣面积和体积测量与暗视RS的相关性更好。[《眼科手术、激光与视网膜成像》。2019；50：e236-e241。]
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