Costa Celso, Nogueira Carlos, Soares Mário, Simão Silvia, Melo Pedro, Silva Rufino, Murta Joaquim, Marques João Pedro
Ophthalmology Department, Unidade Local de Saúde de Coimbra (ULS Coimbra), Coimbra, 3004-561, Portugal.
Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal.
Int J Retina Vitreous. 2024 Nov 22;10(1):89. doi: 10.1186/s40942-024-00608-7.
To evaluate self-reported visual function in retinitis pigmentosa (RP) patients with and without cystoid macular edema (CME) and to explore associations between cystoid spaces (CS), retinal morphometric parameters, and clinical data using swept-source optical coherence tomography (SS-OCT).
In this cross-sectional case-control study (1:3) conducted at an Inherited Retinal Degenerations referral center in Portugal, RP patients with and without CME (matched for age and gender) completed the Michigan Retinal Degeneration Questionnaire (MRDQ) and underwent SS-OCT. Morphometric analysis, including ellipsoid zone area (EZA), was performed by two independent graders. In the CME group, detailed CS analysis was conducted. Correlations between clinical data - age, gender, best-corrected visual acuity (BCVA) - and MRDQ domains were evaluated.
The study included 23 RP patients with CME (60.87% male, mean age 44.65 ± 13.58 years) and 69 without CME (49.28% male, mean age 47.94 ± 14.39 years). No significant differences were found between groups in almost all MRDQ domains, BCVA, or EZA. Age positively correlated with 4 MRDQ domains in both groups. BCVA negatively correlated with nearly all MRDQ domains. While EZA showed a negative correlation in both groups, it was significant only in RP without CME. In the CME group, centrally located, outer nuclear layer-involving and large CS were associated with worse BCVA but better EZA.
MRDQ responses strongly correlated with clinical parameters. CME does not seem to affect self-reported visual function in RP patients, and CS may not worsen visual function. Thus, aggressive treatment of CME in RP may not be necessary.
评估有无黄斑囊样水肿（CME）的视网膜色素变性（RP）患者的自我报告视觉功能，并使用扫频光学相干断层扫描（SS-OCT）探索囊样间隙（CS）、视网膜形态学参数和临床数据之间的关联。
在葡萄牙一家遗传性视网膜变性转诊中心进行的这项横断面病例对照研究（1:3）中，有无CME的RP患者（年龄和性别匹配）完成了密歇根视网膜变性问卷（MRDQ）并接受了SS-OCT检查。由两名独立的分级人员进行形态学分析，包括椭圆体区面积（EZA）。在CME组中，进行了详细的CS分析。评估临床数据——年龄、性别、最佳矫正视力（BCVA）——与MRDQ各领域之间的相关性。
该研究纳入了23例患有CME的RP患者（男性占60.87%，平均年龄44.65±13.58岁）和69例无CME的患者（男性占49.28%，平均年龄47.94±14.39岁）。两组在几乎所有MRDQ领域、BCVA或EZA方面均未发现显著差异。年龄与两组中的4个MRDQ领域呈正相关。BCVA与几乎所有MRDQ领域呈负相关。虽然EZA在两组中均呈负相关，但仅在无CME的RP患者中具有显著性。在CME组中，位于中央、累及外核层且较大的CS与较差的BCVA相关，但与较好的EZA相关。
MRDQ的回答与临床参数密切相关。CME似乎不会影响RP患者的自我报告视觉功能，且CS可能不会使视觉功能恶化。因此，可能无需对RP患者中的CME进行积极治疗。
