Sheludchenko V M, Smirnova T V, Kozlovskaya N L, Krasnolutskaya E I
Krasnov Research Institute of Eye Diseases, Moscow, Russia.
Peoples' Friendship University of Russia, Moscow, Russia.
Vestn Oftalmol. 2023;139(2):35-43. doi: 10.17116/oftalma202313902135.
This study evaluates the function of the retina according to multifocal electroretinography (mfERG) and its light sensitivity according to microperimetry (MP) in patients with thrombotic microangiopathy (TMA) associated with malignant hypertension (MH).
The study analyzed mfERG and MP data of 20 patients (40 eyes) aged 40.4±7.4 years (18 men, 2 women) with MH-associated TMA. In all patients TMA of the kidneys was verified by nephrobiopsy. The control group consisted of 20 healthy individuals (40 eyes) of the appropriate age.
A statistically significant decrease in the response density of P1 mfERG (nV/deg) of the central retinal zone (0-27.7°) was found in study patients in comparison with the control group (<0.05), differences in the latency of P1 mfERG (ms) were statistically insignificant (>0.05). Analysis of MP data in study patients revealed a statistically significant decrease in the mean light sensitivity (dB) of the central field of vision (30°) (<0.05) compared to the control group. A statistically significant correlation was found between the response density of P1 mfERG (nV/deg) and mean light sensitivity (dB) in the corresponding quadrants of the visual field (<0.05). A number of statistically significant correlations were found between the indicators of MP and mfERG and some non-ocular clinical manifestations of TMA in MH.
A statistically significant decrease in the light sensitivity of the central field of vision caused by marked decrease in retinal function, probably of an ischemic nature, is characteristic for MH-associated TMA. In this disease the response density of P1 mfERG (nV/deg) is a sensitive indicator of impaired retinal function. With the activation of systemic TMA, increase in blood pressure and deterioration of kidney function in MH, the light sensitivity of the eye also decreases.
本研究根据多焦视网膜电图（mfERG）评估血栓性微血管病（TMA）合并恶性高血压（MH）患者的视网膜功能，并根据微视野计（MP）评估其光敏感度。
该研究分析了20例年龄为40.4±7.4岁（18例男性，2例女性）的MH相关性TMA患者（40只眼）的mfERG和MP数据。所有患者均通过肾活检确诊为肾脏TMA。对照组由20名年龄相仿的健康个体（40只眼）组成。
与对照组相比，研究患者视网膜中央区（0-27.7°）P1 mfERG的反应密度（nV/deg）有统计学意义的降低（<0.05），P1 mfERG的潜伏期（ms）差异无统计学意义（>0.05）。对研究患者MP数据的分析显示，与对照组相比，中央视野（30°）的平均光敏感度（dB）有统计学意义的降低（<0.05）。在视野相应象限中，P1 mfERG的反应密度（nV/deg）与平均光敏感度（dB）之间存在统计学意义的相关性（<0.05）。在MP和mfERG指标与MH中TMA的一些非眼部临床表现之间发现了一些统计学意义的相关性。
视网膜功能明显下降，可能具有缺血性质，导致中央视野光敏感度有统计学意义的降低，这是MH相关性TMA的特征。在这种疾病中，P1 mfERG的反应密度（nV/deg）是视网膜功能受损的敏感指标。随着MH中全身TMA的激活、血压升高和肾功能恶化，眼睛的光敏感度也会降低。
