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全视野灵敏度阈值与色素性视网膜炎的氧代谢视网膜功能的关系。

Full-field sensitivity threshold and the relation to the oxygen metabolic retinal function in retinitis pigmentosa.

机构信息

Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland.

Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2022 Aug;260(8):2517-2527. doi: 10.1007/s00417-022-05638-1. Epub 2022 Mar 31.

Abstract

PURPOSE

The aim of our study was to evaluate retinal function with white light dark-adapted full-field sensitivity threshold (FST) and find possible correlations with metabolic function measured with retinal oximetry (RO) in patients with retinitis pigmentosa (RP).

METHODS

In this prospective observational study (BASEC 2020-00,122), FST and RO measurements were performed on 66 RP eyes (33 subjects, 12♀ 21♂) aged between 18 and 80 years (mean 43.2 years); all eyes were graded for disease severity. Main outcome parameters were white FST thresholds using the Diagnosys Espion system with the ColorDomeTM LED full-field stimulator (Diagnosys LLC, Lowell, MA) as well as the main RO parameters: the mean arterial (A-SO; %), venular (V-SO; %) oxygen saturation, their difference (A-V SO; %), and the corresponding mean diameters of the peripapillary retinal arterioles (D-A; μm) and venules (D-V; μm) recorded with the oxygen saturation tool of the Retinal Vessel Analyser (RVA; IMEDOS Systems UG, Jena, Germany). In addition, semi-automated kinetic perimetry (V4e, III4e, I4e, III3e isopters, Octopus 900®, Haag-Streit AG Bern, Switzerland) was performed and included in the linear mixed-effects models analysis calculated with SPSS®.

RESULTS

Neither the oxygen saturation parameters (p > 0.21) nor the D-A and D-V (p > 0.13) showed significant correlations with the FST. However, when compared systematically with the visual field (VF) areas of the different isopters, RO parameters V-SO (p = 0.024) and A-V SO (p < 0.02) showed significant correlations. Furthermore, both V-SO and A-V SO showed gradual changes with more pronounced impairment in oxygen metabolic function in advanced stages of RP when analyzed in subgroups of disease severity grades.

CONCLUSION

In contrast to standardized VF parameters, white dark-adapted FST appears not to correlate with retinal oxygen metabolic function measured with RO in patients with RP, suggesting that the two examinations may capture unrelated aspects of the retinal pathological process. However, RO showed a significant association with standardized VF testing parameters and may, therefore, offer an alternative outcome measure for interventional trials.

摘要

目的

本研究旨在评估患有色素性视网膜炎(RP)的患者的视网膜功能,方法是使用白光暗适应全视野敏感度阈值(FST)进行评估,并结合视网膜血氧饱和度(RO)测量发现可能与代谢功能相关的指标。

方法

这是一项前瞻性观察研究(BASEC 2020-00,122),共纳入 66 只 RP 眼(33 名受试者,12 名女性,21 名男性),年龄 18 至 80 岁(平均年龄 43.2 岁);所有患者均根据疾病严重程度进行分级。主要观察指标是使用 Diagnosys Espion 系统和 ColorDomeTM LED 全视野刺激器(Diagnosys LLC,马萨诸塞州洛厄尔)测量的白色 FST 阈值,以及主要的 RO 参数:视网膜中央动脉(A-SO;%)、视网膜中央静脉(V-SO;%)氧饱和度、它们之间的差异(A-V SO;%),以及用视网膜血管分析仪(RVA;IMEDOS Systems UG,耶拿,德国)的血氧工具记录的相应视盘周围视网膜小动脉(D-A;μm)和小静脉(D-V;μm)的平均直径。此外,还进行了半自动动态视野检查(V4e、III4e、I4e、III3e 等视线,Octopus 900®,哈格斯特赖特 AG 伯尔尼,瑞士),并纳入使用 SPSS®计算的线性混合效应模型分析。

结果

无论是氧饱和度参数(p>0.21)还是 D-A 和 D-V(p>0.13),均与 FST 无显著相关性。然而,当与不同等视线的视野(VF)区域进行系统比较时,RO 参数 V-SO(p=0.024)和 A-V SO(p<0.02)显示出显著相关性。此外,当在疾病严重程度分级的亚组中分析时,V-SO 和 A-V SO 均显示出氧代谢功能逐渐受损,在 RP 的晚期阶段更为明显。

结论

与标准化的 VF 参数相比,白光暗适应 FST 似乎与 RP 患者的 RO 测量的视网膜氧代谢功能不相关,这表明这两种检查可能捕获到视网膜病理过程的不同方面。然而,RO 与标准化的 VF 测试参数具有显著相关性,因此可能为干预试验提供替代的疗效评估指标。

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