Emory University School of Medicine, Atlanta, Georgia, United States.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States.
Invest Ophthalmol Vis Sci. 2020 Nov 2;61(13):33. doi: 10.1167/iovs.61.13.33.
Individuals with pentosan polysulfate sodium (PPS) maculopathy commonly report symptoms of prolonged dark adaptation and difficulty reading. We hypothesize that PPS maculopathy causes degradation of visual function not fully captured with visual acuity testing.
Subjects with PPS maculopathy underwent multimodal evaluation of retinal structure and function. Structural changes were graded as moderate or advanced. Patient-reported visual function was assessed with the National Eye Institute Visual Function Questionnaire 39 (NEI-VFQ-39) and Low Luminance Questionnaire (LLQ). Objective functional evaluations included Early Treatment of Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), Pelli-Robson contrast sensitivity, mesopic microperimetry, and dark adaptometry. Functional testing results were correlated with structural disease category.
Thirteen patients (26 eyes), median age 62 years (range, 37-76), completed the study. Median ETDRS letter score was 82 (Snellen equivalent 20/25). Median NEI-VFQ-39 and LLQ composite scores were 65 (range, 33-88) and 41 (range, 20-92), respectively. Median contrast sensitivity was 1.65 (range, 0.15-1.95), and median mesopic microperimetry average thresholds and percent reduced thresholds were 26 decibels (range, 0.4-28.6) and 21.6% (range, 0-100%), respectively. Median rod intercept time was 14.1 minutes (range, 4.4-20.0). Eyes with advanced disease based on retinal structure had significantly worse retinal function for several testing modalities.
PPS maculopathy causes considerable visual function degradation that is not fully captured with BCVA testing. There was good correlation between other measures of visual function and disease severity. These findings deepen our concern regarding this patient safety issue.
患有聚戊烯多糖硫酸钠（PPS）黄斑病变的个体常报告有较长的暗适应时间延长和阅读困难的症状。我们假设 PPS 黄斑病变导致视力功能下降，而这些下降无法通过视力测试完全捕捉到。
患有 PPS 黄斑病变的受试者接受了视网膜结构和功能的多模态评估。结构变化被评为中度或重度。患者报告的视力功能通过国家眼科研究所视力功能问卷 39 项（NEI-VFQ-39）和低光照问卷（LLQ）进行评估。客观功能评估包括早期糖尿病视网膜病变治疗研究（ETDRS）最佳矫正视力（BCVA）、Pelli-Robson 对比敏感度、中间光微视力和暗适应测量。功能测试结果与结构性疾病类别相关。
13 名患者（26 只眼），中位年龄 62 岁（范围，37-76 岁），完成了研究。中位 ETDRS 字母评分 82（Snellen 等价物 20/25）。中位 NEI-VFQ-39 和 LLQ 综合评分分别为 65（范围，33-88）和 41（范围，20-92）。中位对比敏感度为 1.65（范围，0.15-1.95），中位中间光微视力平均阈值和减少阈值百分比分别为 26 分贝（范围，0.4-28.6）和 21.6%（范围，0-100%）。中位杆截距时间为 14.1 分钟（范围，4.4-20.0）。基于视网膜结构的晚期疾病眼在几种测试模式下的视网膜功能明显更差。
PPS 黄斑病变导致相当大的视力功能下降，而这些下降无法通过 BCVA 测试完全捕捉到。其他几种视力功能测量方法与疾病严重程度有很好的相关性。这些发现加深了我们对这一患者安全问题的关注。
Zotero 插件