Toto Lisa, Battaglia Parodi Maurizio, D'Aloisio Rossella, Mercuri Stefano, Senatore Alfonso, Di Antonio Luca, Di Marzio Guido, Di Nicola Marta, Mastropasqua Rodolfo
Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy.
Scientific Institute San Raffaele, University Vita-Salute, IRCCS, 20131 Milano, Italy.
J Clin Med. 2020 May 16;9(5):1500. doi: 10.3390/jcm9051500.
This study investigates the relationship between retinal vascularization and macular function in patients with cone dystrophies (CDs).
Twenty CD patients (40 eyes) and 20 healthy controls (20 eyes) were enrolled in this prospective case-control study. Patients underwent full ophthalmological examination, microperimetry, full-field, pattern and multifocal electroretinogram (ERG, PERG, mfERG) and optical coherence tomography angiography (OCTA). Main outcome measures were as follows: foveal and parafoveal inner and outer retinal thickness; microperimetry sensitivity in the central 4° and 8°, ERG b wave amplitudes and peak times, PERG P50 and N95 amplitudes and latencies, and mfERG N1 to P1 amplitudes; and superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillary (CC) plexus vessel densities, divided into foveal and parafoveal region.
Retinal thickness, SCP and DCP densities were significantly related to PERG. A significant relationship was found between foveal and parafoveal retinal thicknesses and foveal SCP density ( < 0.001 and = 0.018, respectively) and between parafoveal retinal thickness and parafoveal SCP density ( = 0.002). Foveal and parafoveal retinal thicknesses were significantly related to parafoveal DCP density ( = 0.007 and < 0.001). Foveal and parafoveal retinal thicknesses, foveal SCP and parafoveal DPC densities were significantly reduced in CD patients compared to controls ( < 0.001; = 0.010 and = 0.008, respectively). PERG and mfERG amplitudes were significantly reduced in CD patients compared to controls ( < 0.01).
CD eyes showed reduced retinal thickness significantly related to reduced vessel density, possibly caused by a decreased metabolic demand. In addition, vessel density significantly correlated with loss of function.
本研究调查视锥细胞营养不良（CD）患者视网膜血管形成与黄斑功能之间的关系。
本前瞻性病例对照研究纳入了20例CD患者（40只眼）和20名健康对照者（20只眼）。患者接受了全面的眼科检查、微视野检查、全视野、图形和多焦视网膜电图（ERG、PERG、mfERG）以及光学相干断层扫描血管造影（OCTA）。主要观察指标如下：黄斑中心凹和旁中心凹视网膜内、外层厚度；中央4°和8°区域的微视野敏感度、ERG b波振幅和峰时、PERG P50和N95振幅及潜伏期，以及mfERG N1至P1振幅；浅表毛细血管丛（SCP）、深部毛细血管丛（DCP）和脉络膜毛细血管（CC）丛的血管密度，分为黄斑中心凹和旁中心凹区域。
视网膜厚度、SCP和DCP密度与PERG显著相关。黄斑中心凹和旁中心凹视网膜厚度与黄斑中心凹SCP密度之间存在显著关系（分别为<0.001和=0.018），旁中心凹视网膜厚度与旁中心凹SCP密度之间也存在显著关系（=0.002）。黄斑中心凹和旁中心凹视网膜厚度与旁中心凹DCP密度显著相关（=0.007和<0.001）。与对照组相比，CD患者的黄斑中心凹和旁中心凹视网膜厚度、黄斑中心凹SCP和旁中心凹DPC密度显著降低（分别为<0.001；=0.010和=0.008）。与对照组相比，CD患者的PERG和mfERG振幅显著降低（<0.01）。
CD患者的眼睛显示视网膜厚度降低，这与血管密度降低显著相关，可能是由于代谢需求降低所致。此外，血管密度与功能丧失显著相关。
