Küchle M, Nguyen N X, Schalnus R, Freissler K, Lüchtenberg M, Müller M
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Klin Monbl Augenheilkd. 1994 Apr;204(4):211-6. doi: 10.1055/s-2008-1035519.
Clinical findings in patients with retinitis pigmentosa (RP) frequently include cystoid macular edema (CME) and vitreous pigment dusting (VPD) indicating alterations of the blood-ocular barriers. It was the aim of this study to determine whether alterations of the blood-aqueous barrier (BAB) are present in RP.
Aqueous flare was quantitatively determined in 56 eyes of 29 patients (mean age 36.4 +/- 11.2 years) with RP using the noninvasive laser flare-cell photometer (Kowa FC-1000, Tokyo, Japan). All RP patients had common forms of RP with markedly reduced or nondetectable ERG. The presence of CME and VPD was determined semiquantitatively by biomicroscopy. Fifty-eight eyes of 58 normal controls (mean age 38.2 +/- 8.5 y.) were also examined.
Aqueous-flare values were significantly higher in RP eyes (mean 9.65 +/- 3.24 photon counts/ms, range 4.0-18.1) than in the normal control eyes (mean 3.89 +/- 1.05, range 1.9-6.0, p < 0.0001, Mann-Whytney test). Forty-eight of the 56 RP eyes (86%) showed increased flare values (> 6.0 photon counts/ms). RP eyes with moderate to marked CME (n = 11) had significantly higher flare values (mean 14.66 +/- 1.92) than RP eyes without or with only questionable CME (8.52 +/- 2.18, p < 0.0001), and RP eyes with moderate to marked VPD (n = 17) had significantly higher (12.05 +/- 2.84) flare values than RP eyes without or with only minimal VPD (8.74 +/- 2.22, p < 0.0005).
Our findings show that the majority of patients with RP have alterations of the BAB with consecutively increased aqueous protein concentrations. The impairment of the BAB appears to be associated with CME and VPD. Measurement of aqueous flare in RP allows quantification of the impairment of the BAB and may be helpful in the future in choosing and monitoring patients with RP and CMP for possible antiinflammatory or antiedematous therapeutic measures.
视网膜色素变性（RP）患者的临床症状常包括黄斑囊样水肿（CME）和玻璃体色素沉着（VPD），提示血眼屏障发生改变。本研究旨在确定RP患者是否存在血-房水屏障（BAB）改变。
使用无创激光闪光细胞光度计（日本东京Kowa FC-1000）对29例RP患者（平均年龄36.4±11.2岁）的56只眼进行了房水闪光定量测定。所有RP患者均为常见类型的RP，视网膜电图（ERG）明显降低或无法检测到。通过生物显微镜对CME和VPD的存在进行半定量测定。还检查了58名正常对照者（平均年龄38.2±8.5岁）的58只眼。
RP患者眼的房水闪光值（平均9.65±3.24光子计数/毫秒，范围4.0 - 18.1）显著高于正常对照者眼（平均3.89±1.05，范围1.9 - 6.0，p < 0.0001，Mann-Whytney检验）。56只RP眼中有48只（86%）闪光值升高（> 6.0光子计数/毫秒）。中度至重度CME的RP眼（n = 11）的闪光值（平均14.66±1.92）显著高于无CME或仅有可疑CME的RP眼（8.52±2.18，p < 0.0001），中度至重度VPD的RP眼（n = 17）的闪光值（12.05±2.84）显著高于无VPD或仅有轻微VPD的RP眼（8.74±2.22，p < 0.0005）。
我们的研究结果表明，大多数RP患者存在BAB改变，随之房水蛋白浓度升高。BAB受损似乎与CME和VPD有关。测定RP患者的房水闪光可对BAB受损程度进行量化，未来可能有助于选择和监测RP和CMP患者，以便采取可能的抗炎或抗水肿治疗措施。
