Kumar Karthik, Sen Sagnik, Anudeep Kannegolla, Rajan Renu P, Kannan Naresh Babu, Ramasamy Kim
Department of Retina and Vitreous Services, Aravind Eye Hospital, Madurai, India.
Graefes Arch Clin Exp Ophthalmol. 2022 Feb;260(2):415-423. doi: 10.1007/s00417-021-05228-7. Epub 2021 Jul 3.
Photic retinopathy may lead to permanent foveal structural injury, leading to irreversible visual acuity loss.
This prospective observational study evaluated 51 eyes of 30 patients with photic retinopathy. Optical coherence tomography (OCT) imaging was performed for all the eyes at baseline and final follow-up. All the eyes showed a focal outer retinal defect on spectral-domain OCT (SD-OCT) at the junction of the inner and outer photoreceptor segments. SD-OCT was used to measure central macular thickness, maximum horizontal dimension of the defect, maximum defect thickness, and the photic retinopathy index (PRI) through the foveal raster scan.
Although PRI improved significantly at the final follow-up from baseline with a 17% improvement in PRI after a period of 6 months in photic retinopathy eyes, visual acuity declined for 14% of the patients and was stable for 84%. There was mild correlation of visual acuity with baseline PRI. Baseline PRI was significantly higher in eyes with poorer presenting visual acuity (VA). In total, 33.3% of the eyes showed partial ellipsoid zone recovery at 6 months. The area under curve of the receiver operator characteristic curve for partial ellipsoid zone recovery with the mean baseline PRI as the independent variable was poor at 0.612.
OCT-based ultrastructural features in photic retinopathy seem to have poor correlation with presenting or final visual acuity. To the best of our knowledge, this is the largest study on longitudinal OCT evaluation of photic retinopathy eyes in literature.
光性视网膜病变可能导致黄斑中心凹永久性结构损伤,从而导致不可逆的视力丧失。
这项前瞻性观察性研究评估了30例光性视网膜病变患者的51只眼睛。在基线和最终随访时对所有眼睛进行光学相干断层扫描(OCT)成像。所有眼睛在光谱域OCT(SD-OCT)上的内外感光细胞段交界处均显示局灶性视网膜外层缺损。通过黄斑中心凹光栅扫描,使用SD-OCT测量中心黄斑厚度、缺损的最大水平尺寸、最大缺损厚度和光性视网膜病变指数(PRI)。
尽管在最终随访时PRI较基线有显著改善,光性视网膜病变眼睛在6个月后PRI提高了17%,但14%的患者视力下降,84%的患者视力稳定。视力与基线PRI存在轻度相关性。初始视力较差(VA)的眼睛基线PRI显著更高。总体而言,33.3%的眼睛在6个月时显示部分椭圆体带恢复。以平均基线PRI为自变量的部分椭圆体带恢复的受试者操作特征曲线下面积较差,为0.612。
光性视网膜病变基于OCT的超微结构特征似乎与初始或最终视力的相关性较差。据我们所知,这是文献中关于光性视网膜病变眼睛纵向OCT评估的最大规模研究。