Discipline of Optometry, Faculty of Health, University of Canberra, ACT, Australia.
John Curtin School of Medical Research (JCSMR), The Australian National University, Canberra, ACT Australia.
Transl Vis Sci Technol. 2021 Feb 5;10(2):10. doi: 10.1167/tvst.10.2.10.
Patients with advanced age-related macular degeneration (AMD) may have preserved visual function despite significant retinal structural changes. We aimed to evaluate the relationships among retinal thickness, macular sensitivity, and visual acuity (VA) in advanced AMD.
We examined 43 eyes of 22 patients with advanced AMD (ages 66-93 years), prospectively recruited from the Canberra Hospital Ophthalmology Department. Visual function was measured on participants with low and high contrast visual acuity (LCVA and HCVA) and 10-2 Matrix visual fields. Retinal structure was determined with spectral domain optical coherence tomography (OCT), and customized software mapped the 64 OCT macular thickness regions onto the 44 regions of the 10-2 test.
Median retinal thickness at each 10-2 region was near normal. Just 7 of 88 regions from the OCT analysis that were thicker than the median had sensitivity that declined significantly with increasing thickness (r = -0.698 ± 0.082, mean ± SD), whereas 17 of 88 thinner regions showed significantly decreasing sensitivity with decreasing thickness (r = 0.723 ± 0.078). The absolute value of deviations from median optical coherence tomography thickness (aOCT) outside the central eight degrees was significantly correlated with HCVA (r = -0.34, P = 0.047). Thickness in the central eight degrees was not. Similarly, matrix sensitivities inside the central eight degrees were significantly correlated with outer aOCT (r = -0.49, P = 0.002).
Retinal thickness outside eight degrees were significantly associated with HCVA and macular sensitivity. These results suggest that outer macular thickness may be a useful prognostic indicator in AMD.
Retinal structure at the borders of the macula may be a surrogate marker of vision and retinal thickness near fixation.
尽管视网膜结构发生了显著变化，但老年黄斑变性（AMD）患者的视力功能可能仍保持完好。本研究旨在评估晚期 AMD 患者的视网膜厚度、黄斑敏感性和视力（VA）之间的关系。
我们前瞻性地招募了来自堪培拉医院眼科的 22 名晚期 AMD 患者（年龄 66-93 岁）的 43 只眼进行研究。使用低对比视力（LCVA 和 HCVA）和 10-2 矩阵视野检查测量参与者的视觉功能。使用频域光相干断层扫描（OCT）确定视网膜结构，并使用定制软件将 64 个 OCT 黄斑厚度区域映射到 10-2 测试的 44 个区域。
每个 10-2 区域的黄斑平均视网膜厚度接近正常。在 OCT 分析中，88 个区域中有 7 个区域的厚度超过中位数，其敏感性随着厚度的增加而显著下降（r = -0.698 ± 0.082，平均值 ± 标准差），而 88 个较薄区域中有 17 个区域的敏感性随着厚度的降低而显著下降（r = 0.723 ± 0.078）。超出中央 8 度的 OCT 厚度中位数的偏差绝对值与 HCVA 显著相关（r = -0.34，P = 0.047）。中央 8 度内的厚度没有相关性。同样，中央 8 度内的矩阵灵敏度与外 OCT 显著相关（r = -0.49，P = 0.002）。
超出 8 度的视网膜厚度与 HCVA 和黄斑敏感性显著相关。这些结果表明，黄斑外的视网膜厚度可能是 AMD 的一个有用的预后指标。
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