Department of Ophthalmology, LIM-33, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Department of Ophthalmology, Universidade Federal do Paraná, Curitiba, Brazil.
Acta Ophthalmol. 2021 Aug;99(5):e715-e723. doi: 10.1111/aos.14646. Epub 2020 Oct 30.
To evaluate associations between functional and structural measurements in patients with non-acute VKHD.
In this cross-sectional study, 16 non-acute VKHD patients (32 eyes; 14 female) were evaluated with multifocal electroretinogram (mfERG), standardized automated perimetry (SAP) and optical coherence tomography (OCT)examinations. All included patients had a minimum 12 months of follow-up from acute onset and were participants of an ongoing prospective study since acute phase with systematic clinical imaging evaluations and electroretinogram examinations within a predefined treatment. Age- and gender-matched controls were included. Main outcomes were functional and structural abnormalities and their correlation; secondary outcome was correlation of these findings with clinical characteristics, including fundus abnormalities.
SAP and mfERG parameters were significantly worse in patients than in controls. Fourteen eyes (43.7%) had disrupted ellipsoid zone (EZ); visual acuity (VA) was similar between eyes with intact or disrupted EZ. Eyes with intact and disrupted EZ differed significantly concerning N1 and P1 amplitudes and N1 peak time values on mfERG and mean sensitivity (MS), central sensitivity (CS), foveal threshold, visual field index, mean deviation (MD) and pattern standard deviation values on SAP. The area under the curve on receiver operating curves for P1 amplitude was 0.81 (cut-off value = 34.7 nV/deg ) and for MD value was 0.84 (cut-off value = -5.2 dB). Central retinal thickness (CRT) significantly correlated with N1 and P1 amplitudes and P1 peak time values on mfERG (r = 0.354, r = 0.442 and r = -0.405, respectively) and MD, MS, CS and fovea threshold (log values) on SAP (r = 0.372, r = 0.406, r = 0.431 and r = 0.414, respectively). Statistically significant associations were found with the presence of peripapillary atrophy and recurrent anterior uveitis with a worse MD value (p = 0.004 and p < 0.001, respectively).
In non-acute VKHD, disrupted EZ and reduced CRT were correlated with impaired mfERG and SAP parameters, even in patients with good VA.
评估非急性期 VKHD 患者的功能和结构测量之间的关联。
在这项横断面研究中，对 16 名非急性期 VKHD 患者（32 只眼；14 名女性）进行了多焦视网膜电图（mfERG）、标准自动视野计（SAP）和光学相干断层扫描（OCT）检查。所有纳入的患者在急性发病后至少有 12 个月的随访，并在急性发病后参与了一项正在进行的前瞻性研究，对眼底影像学和视网膜电图进行系统评估。纳入年龄和性别匹配的对照组。主要结局为功能和结构异常及其相关性；次要结局为这些发现与临床特征（包括眼底异常）的相关性。
与对照组相比，SAP 和 mfERG 参数在患者中明显更差。14 只眼（43.7%）出现椭圆体带（EZ）中断；EZ 完整或中断的视力（VA）相似。EZ 完整和中断的眼睛在 mfERG 的 N1 和 P1 幅度以及 N1 峰时间值和 SAP 的平均敏感度（MS）、中央敏感度（CS）、中央阈值、视野指数、平均偏差（MD）和模式标准差值方面存在显著差异。P1 幅度的接收器工作曲线下面积为 0.81（截断值=34.7 nV/deg），MD 值为 0.84（截断值=-5.2 dB）。中央视网膜厚度（CRT）与 mfERG 的 N1 和 P1 幅度和 P1 峰时间值（r=0.354、r=0.442 和 r=-0.405）以及 SAP 的 MD、MS、CS 和中央凹阈值（对数）呈显著相关（r=0.372、r=0.406、r=0.431 和 r=0.414）。与视盘周围萎缩和复发性前葡萄膜炎的存在呈统计学显著关联，MD 值更差（p=0.004 和 p<0.001）。
在非急性期 VKHD 中，EZ 中断和 CRT 降低与 mfERG 和 SAP 参数受损相关，即使在 VA 良好的患者中也是如此。
