Tezel T H, Del Priore L V, Flowers B E, Grosof D H, Benenson I L, Zamora R L, Kaplan H J
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO 63110, USA.
Ophthalmology. 1996 Nov;103(11):1829-36. doi: 10.1016/s0161-6420(96)30419-3.
The purpose of the study is to identify the anatomic abnormalities associated with an absolute scotoma and the location and stability of fixation in patients with subfoveal neovascularization in age-related macular degeneration, presumed ocular histoplasmosis syndrome, and other disorders.
Scanning laser ophthalmoscope microperimetry was superimposed on color fundus photographs and fluorescein angiograms of 21 eyes with subfoveal neovascular membranes secondary to age-related macular degeneration (14 eyes) and presumed ocular histoplasmosis syndrome (7 eyes). The authors determined the location and the area occupied by the absolute scotoma and each of the following subretinal lesions: subretinal hemorrhage, neurosensory retinal detachment, retinal pigment epithelial (RPE) atrophy, RPE hyperplasia, atrophy of the choriocapillaris, hard exudates, and the subfoveal neovascular membrane. The area of absolute scotoma determined by scanning laser ophthalmoscope microperimetry was superimposed on the anatomic lesions. The authors calculated the relative risk ratio (RR) of an absolute scotoma occurring in regions corresponding to each anatomic abnormality, and determined the preferred location and stability of fixation in each eye.
An absolute scotoma was present in areas of chorioretinal scar (RR = 107.61), RPE atrophy (RR = 9.97), subretinal hemorrhage (RR = 2.88), and the neovascular membrane (RR = 1.86). Fixation was stable in all patients with presumed ocular histoplasmosis syndrome but only 29% of patients with age-related macular degeneration. Fifty-five percent of patients with stable fixation fixated over an area of RPE hyperplasia.
The relative risk of an absolute scotoma is highest over areas of chorioretinal scars, RPE atrophy, subretinal hemorrhage, and the neovascular membrane. Fixation is more stable in patients with subfoveal neovascularization from presumed ocular histoplasmosis syndrome than with age-related macular degeneration and frequently is present over an area of RPE hyperplasia.
本研究旨在确定与绝对暗点相关的解剖异常，以及年龄相关性黄斑变性、疑似眼组织胞浆菌病综合征和其他疾病患者中黄斑下新生血管形成时注视点的位置和稳定性。
将扫描激光检眼镜微视野检查叠加于21只患有黄斑下新生血管膜的眼睛的彩色眼底照片和荧光素血管造影上，这些患者继发于年龄相关性黄斑变性（14只眼）和疑似眼组织胞浆菌病综合征（7只眼）。作者确定了绝对暗点以及以下每种视网膜下病变所占据的位置和面积：视网膜下出血、神经感觉性视网膜脱离、视网膜色素上皮（RPE）萎缩、RPE增生、脉络膜毛细血管萎缩、硬性渗出物以及黄斑下新生血管膜。通过扫描激光检眼镜微视野检查确定的绝对暗点面积叠加于解剖病变上。作者计算了在与每种解剖异常相对应的区域出现绝对暗点的相对风险比（RR），并确定了每只眼中注视点的首选位置和稳定性。
在脉络膜视网膜瘢痕（RR = 107.61）、RPE萎缩（RR = 9.97）、视网膜下出血（RR = 2.88）和新生血管膜（RR = 1.86）区域存在绝对暗点。在所有疑似眼组织胞浆菌病综合征患者中注视稳定，但在年龄相关性黄斑变性患者中仅29%注视稳定。55%注视稳定的患者注视于RPE增生区域。
在脉络膜视网膜瘢痕、RPE萎缩、视网膜下出血和新生血管膜区域，出现绝对暗点的相对风险最高。与年龄相关性黄斑变性相比，疑似眼组织胞浆菌病综合征导致黄斑下新生血管形成的患者注视更稳定，且通常位于RPE增生区域。
