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中心性浆液性脉络膜视网膜病变中的暗适应延迟

Delayed dark adaptation in central serous chorioretinopathy.

作者信息

Nigalye Archana, Pundlik Shrinivas, Kim Janice, Luo Gang, Husain Deeba

机构信息

Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford Street, Boston, MA, 02114, USA.

出版信息

Am J Ophthalmol Case Rep. 2021 Apr 21;22:101098. doi: 10.1016/j.ajoc.2021.101098. eCollection 2021 Jun.

Abstract

PURPOSE

To evaluate the effect of central serous chorioretinopathy (CSCR) on retinal function using dark adaptation in a human subject, and to follow it through resolution of the disease.

PATIENTS

Single patient, 50 years old male patient, with acute CSCR in one eye and resolved old CSCR in the other eye.

OBSERVATIONS

Observational study in patient with CSCR followed through resolution of the subretinal fluid (52 days). Dark adaptation was assessed using the AdaptDx® (Maculogix Inc.) measured by Rod Intercept time (RIT) in minutes. A normal retinal locus of the same eye on the opposite side of the fovea was used as control. Retinal separation (microns) was measured using Spectralis Optical Coherence Tomography (Spectralis®, HRA + OCT, Heidelberg engineering). Change in time to dark adapt, were correlated with retinal separation measured in microns, during the course of CSCR.The Rod Intercept time was delayed in the area of detached retina compared to the normal region (control) on presentation with retinal separation (RS) of 104 μm. The Rod Intercept time returned to normal as the retinal separation from retinal pigment epithelium decreased and eventually resolved.

CONCLUSIONS

This case shows that delay in dark adaptation is proportional to the amount of separation of neurosensory retina from retinal pigment epithelium in CSCR, this may offer a potential of using DA to characterize visual function in CSCR. The association of dark adaptation response with the state of retinal pigment epithelial function and its ability to predict the recurrence of CSCR needs further evaluation.

摘要

目的

通过对一名人类受试者进行暗适应评估,以评价中心性浆液性脉络膜视网膜病变(CSCR)对视网膜功能的影响,并在疾病消退过程中进行跟踪观察。

患者

单例患者,50岁男性,一只眼患有急性CSCR,另一只眼为已消退的陈旧性CSCR。

观察结果

对CSCR患者进行观察性研究,跟踪观察视网膜下液消退情况(52天)。使用AdaptDx®(Maculogix公司)通过视杆细胞截距时间(RIT,以分钟为单位)评估暗适应。将同一只眼在黄斑中心凹对侧的正常视网膜部位作为对照。使用Spectralis光学相干断层扫描(Spectralis®,HRA + OCT,海德堡工程公司)测量视网膜脱离(微米)。在CSCR病程中,暗适应时间的变化与以微米为单位测量的视网膜脱离情况相关。在视网膜脱离(RS)为104μm时,与正常区域(对照)相比,脱离视网膜区域的视杆细胞截距时间延迟。随着神经感觉视网膜与视网膜色素上皮的脱离程度降低并最终消退,视杆细胞截距时间恢复正常。

结论

该病例表明,CSCR中暗适应延迟与神经感觉视网膜与视网膜色素上皮的脱离程度成正比,这可能为利用暗适应来表征CSCR中的视觉功能提供了一种潜力。暗适应反应与视网膜色素上皮功能状态的关联及其预测CSCR复发的能力需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/8094908/c58d14b9ca46/gr1.jpg

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