Minnella Angelo Maria, Piccardi Marco, Placidi Giorgio, García-Layana Alfredo, Delcourt Cecile, Valentini Patrizia, Falsini Benedetto
Ophthalmology, Università Cattolica del Sacro Cuore, Rome, Italy.
Fondazione Policlinico Universitario A. Gemelli- IRCCS, Rome, Italy.
Transl Vis Sci Technol. 2020 Sep 28;9(10):28. doi: 10.1167/tvst.9.10.28. eCollection 2020 Sep.
Early detection of retinal dysfunction in age-related macular degeneration (AMD) may be important for both prevention and treatment. The aim of this study was to evaluate in early and intermediate AMD the correlation of macular function, assessed by the focal electroretinogram (fERG), with the Simplified Thea Risk Assessment Scale (STARS), a simple 13-item self-administered questionnaire.
We recorded a fERG (18°, 41 Hz) in 84 patients with AMD (40 male and 44 female, age 55-87 years, visual acuity 20/40-20/20), who had undergone a 5-year clinical ophthalmic and general follow-up. Sixty-six patients had early and 17 patients intermediate AMD. Fifty healthy subjects, in a comparable age range, served as controls. The fERG amplitude (in microVolts) was the main outcome variable. STARS was calculated for each patient.
Compared with controls, fERG amplitudes were significantly reduced, on average, in both early and intermediate patients with AMD ( < 0.01). In both groups, fERG amplitudes tended to decrease with age and to increase with visual acuity and were negatively correlated with STARS (early r = -0.6, < 0.01; intermediate, r = -0.50, < 0.05). fERG losses were greatest in patients with a STARS score of greater than 20.
In early and intermediate AMD, STARS robustly predicted central retinal function, as assessed by fERG, supporting the combined use of both parameters to estimate the clinical risk of visual function loss.
The STARS may predict macular function in AMD and could be used in the daily clinical practice to estimate the risk of visual function loss in early disease stages.
年龄相关性黄斑变性（AMD）中视网膜功能障碍的早期检测对于预防和治疗可能都很重要。本研究的目的是在早期和中期AMD患者中评估通过焦点视网膜电图（fERG）评估的黄斑功能与简化的西娅风险评估量表（STARS）之间的相关性，STARS是一份简单的包含13个项目的自填式问卷。
我们对84例AMD患者（40例男性和44例女性，年龄55 - 87岁，视力20/40 - 20/20）进行了fERG（18°，41Hz）记录，这些患者均已接受了为期5年的临床眼科和全身随访。其中66例患者为早期AMD，17例为中期AMD。50名年龄范围相当的健康受试者作为对照。fERG振幅（以微伏为单位）是主要的观察变量。为每位患者计算STARS得分。
与对照组相比，早期和中期AMD患者的fERG振幅平均显著降低（P < 0.01）。在两组中，fERG振幅均倾向于随年龄增长而降低，随视力提高而增加，并且与STARS呈负相关（早期r = -0.6，P < 0.01；中期，r = -0.50，P < 0.05）。STARS评分大于20的患者fERG损失最大。
在早期和中期AMD中，STARS能够可靠地预测通过fERG评估的视网膜中央功能，支持联合使用这两个参数来估计视觉功能丧失的临床风险。
STARS可能预测AMD中的黄斑功能，并可在日常临床实践中用于估计疾病早期视觉功能丧失的风险。
