Michaud Langis, Garon Marie-Lou, Forcier Pierre, Diaconu Vasile
École d'optométrie de l'Université de Montréal, Montréal, Canada.
Clin Ophthalmol. 2022 Jun 9;16:1893-1908. doi: 10.2147/OPTH.S356245. eCollection 2022.
This study aims to evaluate potential causes of FDT visual field loss in a selected group of Fabry subjects.
This is a pilot observational study. Subjects were assessed during 2 visits. The following tests were performed: visual acuity, tonometry, optical coherence tomography (OCT) optic nerve scan, frequency doubling time (FDT) and threshold (SAP) VF, ERG, and Online Spectro-reflectometry Oxygenation Measurement in the Eye (OSOME). Results are compared across visits and, when indicated, interpreted against those collected on non-Fabry population matched for age and sex.
The study population was composed of 3 males (34.3 ± 8.9 y.o.) and 5 females (46.4 ± 6.5 y.o). For all subjects, BCVA remained 6/6 OU throughout the study and OCT optic nerve scans were normal. FDT showed a defect in at least 1 quadrant for all participants, in contrast with SAP. FDT PSD value was found different vs SAP. For ERG, the i-wave (52.1 + 2.7 ms) and B-waves (31.6 ± 2.1 ms) peak times were significantly longer compared to a non-Fabry population (p < 0.05). Overall blood oxygenation varied from 61.3% ± 4% to 68.1% ± 4% at the second visit, suggesting a loss of capillary perfusion. Blood volume varied based on location (superior/inferior), eye tested (OD/OS) and time (visit 1/2). The range of values exceeds normal subjects findings (p < 0.05). Blood volume was correlated to FDT PSD value for the superior area of the optic nerve.
The results suggest that Fabry subjects present FDT deficits and abnormal ERG patterns that may be explained by a retinal dysfunction affecting retinal ganglion cells (RGCs), second to vascular alterations.
本研究旨在评估一组选定的法布里病患者中FDT视野缺损的潜在原因。
这是一项初步观察性研究。受试者在两次就诊期间接受评估。进行了以下检查:视力、眼压测量、光学相干断层扫描(OCT)视神经扫描、频率加倍视野检查(FDT)和阈值视野检查(SAP)、视网膜电图(ERG)以及眼部在线光谱反射氧合测量(OSOME)。对两次就诊的结果进行比较,并在必要时与年龄和性别匹配的非法布里病患者群体的结果进行对照解读。
研究人群包括3名男性(34.3±8.9岁)和5名女性(46.4±6.5岁)。对于所有受试者,在整个研究过程中双眼最佳矫正视力(BCVA)均保持在6/6,且OCT视神经扫描结果正常。与SAP相比,FDT显示所有参与者至少有一个象限存在缺损。发现FDT PSD值与SAP不同。对于ERG,与非法布里病患者群体相比,i波(52.1 + 2.7毫秒)和B波(31.6±2.1毫秒)的峰值时间明显更长(p < 0.05)。第二次就诊时总体血氧饱和度从61.3%±4%变化到68.1%±4%,提示毛细血管灌注丧失。血容量因位置(上方/下方)、检查眼别(右眼/左眼)和时间(就诊1/就诊2)而有所不同。这些值的范围超过了正常受试者的结果(p < 0.05)。视神经上方区域的血容量与FDT PSD值相关。
结果表明,法布里病患者存在FDT缺陷和异常的ERG模式,这可能是由于继发于血管改变的视网膜功能障碍影响视网膜神经节细胞(RGCs)所致。