de Albuquerque Marina L, Correa Zelia, Messias André, Jorge Rodrigo
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Bascom Palmer Eye Institute, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA.
Ocul Oncol Pathol. 2021 Sep;7(4):287-293. doi: 10.1159/000515561. Epub 2021 May 6.
To report retinal function findings on the choroidal nevus.
Prospective descriptive case series of 7 patients ( = 7 eyes) presenting a melanocytic choroidal lesion consistent with choroidal nevus and no other ocular disease. Baseline evaluation included measurement of best-corrected visual acuity (BCVA), color and near-infrared fundus pictures, and spectral-domain OCT (Heidelberg Engineering). Retinal function was tested with microperimetry (MAIA; CenterVUE, Padova) using a standard grid (µP1) and a linear grid (µP2) that distribute test points on retinal areas that overlaid the choroidal lesion as well as lesion-free areas equidistantly to the fovea in 3 parallel lines. mfERG was performed following the International Society for Clinical Electrophysiology of Vision (ISCEV) recommendation using a 61-hexyagon protocol.
BCVA was 20/25 (0.1 logMAR) or better in all 7 eyes. Microperimetry showed central stable fixation on all eyes, with mean ± SE sensitivity threshold significantly decreased on retinal areas overlaying the lesions (µP1): 21.8 ± 0.6 dB versus 25.2 ± 0.9 dB on nonaffected retinal areas ( < 0.001). Sensitivity was also decreased on µP2: 23.7 ± 0.2 dB for areas overlying the nevi and 25.7 ± 0.3 dB for the nonaffected retina ( < 0.001). mfERG responses showed no focal amplitude or implicit-time changes on the retina in the topographical region corresponding to the nevus for all patients.
Our results indicate that choroidal nevi may cause significant retinal sensitivity impairment, as shown by microperimetry, but preserved mfERG response indicates that the retinal function may be only partially impaired.
报告脉络膜痣的视网膜功能检查结果。
对7例患者(7只眼)进行前瞻性描述性病例系列研究,这些患者均有符合脉络膜痣的黑素细胞性脉络膜病变且无其他眼部疾病。基线评估包括测量最佳矫正视力(BCVA)、彩色和近红外眼底照片以及光谱域光学相干断层扫描(海德堡工程公司)。使用标准网格(µP1)和线性网格(µP2)通过微视野计(MAIA;CenterVUE,帕多瓦)测试视网膜功能,这两种网格将测试点分布在覆盖脉络膜病变的视网膜区域以及与中央凹等距的3条平行线上的无病变区域。按照国际临床视觉电生理学会(ISCEV)的建议,采用61六边形协议进行多焦视网膜电图(mfERG)检查。
所有7只眼的BCVA均为20/25(0.1 logMAR)或更好。微视野计显示所有眼睛的中心注视稳定,在覆盖病变的视网膜区域(µP1)平均±标准误敏感度阈值显著降低:21.8±0.6 dB,而在未受影响的视网膜区域为25.2±0.9 dB(P<0.001)。µP2上的敏感度也降低:覆盖痣的区域为23.7±0.2 dB,未受影响的视网膜为25.7±0.3 dB(P<0.001)。所有患者的mfERG反应在对应痣的地形图区域的视网膜上均未显示出局部振幅或隐含时间变化。
我们的结果表明,脉络膜痣可能会导致显著的视网膜敏感度损害,如微视野计所示,但mfERG反应正常表明视网膜功能可能仅部分受损。