Sharief Lazha, Chen Yi-Hsing, Lightman Sue, Tomkins-Netzer Oren
Moorfields Eye Hospital, London, UK.
UCL Institute of Ophthalmology, London, UK.
Graefes Arch Clin Exp Ophthalmol. 2020 Sep;258(9):1941-1947. doi: 10.1007/s00417-020-04715-7. Epub 2020 May 2.
Retinal sensitivity (RS) can be a valuable indicator of retinal function in response to intravitreal steroid or anti-VEGF treatment in the eyes with diabetic macular edema (DME), macular edema post retinal vein occlusion (RVO), or uveitis.
This prospective longitudinal study included 68 patients (96 eyes) with macular edema (ME) secondary to diabetes mellitus (42 eyes), uveitis (36 eyes), or RVO (18 eyes). In addition to best corrected visual acuity (BCVA) and retinal thickness, Nidek MP1 microperimetry was used to quantify RS at baseline visit and to look at the mean difference (MD) at 3-6 months and 1-2 years post intravitreal therapy with corticosteroids or anti-VEGF.
There was a significant negative correlation between the central RS and BCVA (r = - 0.47, p < 0.001), including DME (r = - 0.42, p = 0.006) and uveitis (r = - 0.60, p < 0.001), but not RVO (r = - 0.37, p = 0.12). At 2-year follow-up, the overall CST was reduced from baseline (MD - 147 μm, 95% C.I - 192 to - 102, p < 0.001) with improved BCVA (MD - 0.12 LogMAR, 95% C.I - 0.23 to - 0.01, p = 0.01), but no improvement in the RS in any of the disorders. Both anti-VEFG and steroid groups showed significant improvement in CST at 2 years from baseline (MD - 101 μm, p = 0.001 and - 167 μm, p < 0.001, respectively) with only improvement in BCVA among anti-VEGF group (MD - 0.16 LogMAR, 95% C.I - 0.26 to - 0.07, p = 0.008).
The long-term follow-up of ME cases did not show a significant improvement in RS following treatment even with reduced macular thickness at 2-year follow-up.
视网膜敏感度（RS）可作为糖尿病性黄斑水肿（DME）、视网膜静脉阻塞（RVO）后黄斑水肿或葡萄膜炎患者眼内注射类固醇或抗血管内皮生长因子（anti-VEGF）治疗后视网膜功能的重要指标。
这项前瞻性纵向研究纳入了68例黄斑水肿（ME）患者（96只眼），其中继发于糖尿病的有42只眼，葡萄膜炎的有36只眼，RVO的有18只眼。除了最佳矫正视力（BCVA）和视网膜厚度外，使用尼德克MP1微视野计在基线检查时量化RS，并观察玻璃体内注射皮质类固醇或抗VEGF治疗后3 - 6个月和1 - 2年的平均差异（MD）。
中心RS与BCVA之间存在显著负相关（r = - 0.47，p < 0.001）,包括DME（r = - 0.42，p = 0.006）和葡萄膜炎（r = - 0.60，p < 0.001），但RVO患者中未发现显著相关性（r = - 0.37，p = 0.12）。在2年随访时，总体中心视网膜厚度（CST）较基线降低（MD - 147μm，95%置信区间 - 192至 - 102，p < 0.001），BCVA有所改善（MD - 0.12 LogMAR，95%置信区间 - 0.23至 - 0.01，p = 0.01），但任何疾病的RS均未改善。抗VEGF组和类固醇组在2年时CST较基线均有显著改善（MD分别为 - 101μm，p = 0.001和 - 167μm，p < 0.001），仅抗VEGF组的BCVA有所改善（MD - 0.16 LogMAR，95%置信区间 - 0.26至 - 0.07，p = 0.008）。
ME患者的长期随访显示，即使在2年随访时黄斑厚度降低，治疗后RS仍未显著改善。
