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遗传性视网膜疾病患者中外层视网膜囊样变性的患病率及光相干断层扫描分析。

Prevalence and optical coherence tomography analyses of outer retinal tubulations in Chinese population with inherited retinal diseases.

机构信息

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

National Clinical Research Center for Ophthalmic Diseases, Shanghai, China.

出版信息

Eye (Lond). 2024 Feb;38(2):328-334. doi: 10.1038/s41433-023-02686-7. Epub 2023 Aug 8.

Abstract

BACKGROUND

To investigate the prevalence of outer retinal tubulation (ORT) and its correlations with optical coherence tomography (OCT) parameters in Chinese population with inherited retinal diseases (IRDs).

METHODS

This retrospective study enrolled consecutive patients identified with IRDs and referred for genetic testing between February 2016 and April 2021. Clinical characteristics from medical records and features of cross-sectional B-scans were reviewed and analysed. The associations of patient-specific and ocular features with the presence of ORT were evaluated using univariate and multivariate analyses.

RESULTS

Two hundred and three patients (401 eyes) with a mean age of 49.7 ± 16.7 years were enrolled. ORT was observed in 41 eyes (10.2%), including 26 of 28 eyes (92.9%) with Bietti crystalline corneoretinal dystrophy (BCD), 14 of 338 eyes (4.1%) with retinitis pigmentosa (RP), and 1 of 26 eyes (3.8%) in eyes with cone-rod dystrophy. Eyes with ORT showed significantly worse visual acuity than those without ORT (P = 0.002). Multivariate analysis indicated that the presence of ORT was positively correlated with choroidal atrophy and inner nuclear layer (INL) cysts (P < 0.01). ORTs were detected more frequently in eyes with BCD than RP (P = 0.024), most of which located exclusively within the extrafoveal area. Large choroidal vessels were detected underneath the corresponding ORTs in both patients with BCD and RP.

CONCLUSIONS

The prevalence of ORT varies among different IRDs phenotypes, with the highest prevalence in BCD. The presence of choroidal atrophy and INL cysts may be associated with an increased risk of ORT formation in patients with IRD.

摘要

背景

本研究旨在调查中国遗传性视网膜疾病(IRDs)患者中发生脉络膜视网膜管扩张(ORT)的患病率及其与光学相干断层扫描(OCT)参数的相关性。

方法

本回顾性研究纳入了 2016 年 2 月至 2021 年 4 月间因 IRDs 就诊并行基因检测的连续患者。对病历中的临床特征和横断面 B 扫描特征进行了回顾和分析。采用单变量和多变量分析评估患者特征和眼部特征与 ORT 发生的相关性。

结果

共纳入 203 名患者(401 只眼),平均年龄为 49.7±16.7 岁。41 只眼中(10.2%)观察到 ORT,其中 28 只眼中的 26 只(92.9%)为 Bietti 结晶状角膜视网膜营养不良(BCD),338 只眼中的 14 只(4.1%)为视网膜色素变性(RP),26 只眼中的 1 只(3.8%)为 Cone-rod dystrophy。ORT 眼的视力明显差于无 ORT 眼(P=0.002)。多变量分析表明,ORT 的存在与脉络膜萎缩和内核层(INL)囊肿呈正相关(P<0.01)。与 RP 相比,BCD 患者的 ORT 更常见(P=0.024),且大多数仅位于中心凹外。在 BCD 和 RP 患者中,均在相应的 ORT 下方检测到较大的脉络膜血管。

结论

ORT 在不同的 IRD 表型中的发生率不同,在 BCD 中发生率最高。脉络膜萎缩和 INL 囊肿的存在可能与 IRD 患者 ORT 形成的风险增加有关。

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