Hsiao Yu-Ting, Huang Hsiu-Mei, Chen Ta-Ching, Lo Jung, Chen Yung-Jen, Kuo Hsi-Kung, Lee Jong-Jer
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83340, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, Taipei 10041, Taiwan.
Diagnostics (Basel). 2024 Nov 29;14(23):2691. doi: 10.3390/diagnostics14232691.
Although optical coherence tomography (OCT) is useful in determining outer retinal architecture, it may be suboptimal when monitoring subtle changes in retinitis pigmentosa (RP) patients. The aim of this study is to investigate precise microperimetric parameters for disease severity identification in RP patients. A cross-sectional and retrospective study. Thirty-nine eyes of 39 RP patients were included. Associations between logMAR visual acuity (VA), spectral-domain OCT, fundus autofluorescence imaging (FAF), and various microperimetric measures were evaluated. Microperimetric test locations were grouped into "foveal", parafoveal "inner ring", and perifoveal "outer ring". Independent variables were analyzed based on logistic regression, then assessed using area under the receiver operating characteristic curve (AUROC). Among all microperimetric measures, linear regression analysis indicated that mean retinal sensitivity and deep scotoma count at the parafoveal inner ring were the principal parameters associated with decreased VA. The AUROC was highest for deep scotoma count at the inner ring at a value of 0.829, with the cut-off point at 3.5. A visual function index was then established according to the number of parafoveal deep scotoma points, in order of mild (0 points), moderate (1-3 points), and severe (4 or more points). Our microperimetric visual function index also correlated significantly to logMAR VA and previously established FAF patterns. Our study discovered deep scotoma count at the parafoveal inner ring to be a key microperimetric parameter in evaluating vision loss in RP patients. Those with four or more deep scotoma points at the parafoveal inner ring are more likely to have functional low vision.
尽管光学相干断层扫描（OCT）有助于确定视网膜外层结构，但在监测视网膜色素变性（RP）患者的细微变化时可能并不理想。本研究的目的是探讨用于识别RP患者疾病严重程度的精确微视野参数。一项横断面回顾性研究。纳入了39例RP患者的39只眼。评估了对数最小分辨角视力（VA）、光谱域OCT、眼底自发荧光成像（FAF）与各种微视野测量之间的关联。微视野测试位置分为“中央凹”、中央凹旁“内环”和中央凹周围“外环”。基于逻辑回归分析自变量，然后使用受试者操作特征曲线下面积（AUROC）进行评估。在所有微视野测量中，线性回归分析表明，中央凹旁内环的平均视网膜敏感度和深部暗点计数是与视力下降相关的主要参数。内环深部暗点计数的AUROC最高，为0.829，截断点为3.5。然后根据中央凹旁深部暗点的数量建立了一个视觉功能指数，分为轻度（0个点）、中度（1 - 3个点）和重度（4个或更多点）。我们的微视野视觉功能指数也与对数最小分辨角视力和先前建立的FAF模式显著相关。我们的研究发现，中央凹旁内环的深部暗点计数是评估RP患者视力丧失的关键微视野参数。中央凹旁内环有四个或更多深部暗点的患者更有可能出现功能性低视力。
