Midena E, Degli Angeli C, Blarzino M C, Valenti M, Segato T
Institute of Ophthalmology, University of Padova, Italy.
Invest Ophthalmol Vis Sci. 1997 Feb;38(2):469-77.
To study different aspects of macular function in eyes with early age-related macular degeneration (early AMD: drusen with or without retinal pigment epithelium alterations) and normal visual acuity, to obtain a complete evaluation of macular function impairment in early AMD and to study the relationship between macular function and the ophthalmoscopic signs of early AMD.
Forty-seven subjects with early AMD and visual acuity better than 20/25 in at least one eye were studied: 34 patients had bilateral early AMD (group 1), 13 had neovascular AMD in the fellow (nonstudy) eye (group 2). Thirty-six age-matched healthy subjects were used as controls. Thirty degree stereoscopic fundus photographs and fluorescein angiography were performed to grade macular lesions. Macular recovery function, central visual field sensitivity, spatiotemporal contrast sensitivity, and the Farnsworth-Munsell 100 hue test were used to study different aspects of macular function.
Except for color vision, all macular function tests were significantly impaired in eyes of patients with early AMD compared to those in control subjects. No functional difference was found between groups 1 and 2. The increase in drusen number negatively influenced macular recovery function. Increasing drusen confluence reduced macular recovery function as well as central visual field sensitivity and some selected spatial frequencies of spatiotemporal contrast sensitivity. Geographic atrophy of the retinal pigment epithelium and focal hyperpigmentation reduced macular recovery function and contrast sensitivity at the highest spatial frequency.
Macular recovery function central visual field sensitivity, and spatiotemporal contrast sensitivity are adequate and reliable indicators of macular function impairment in early AMD. Macular recovery function is the test that best reflects the ophthalmoscopic characteristics of early AMD because its deterioration parallels the worsening of typical fundus lesions. Function tests are valuable in the evaluation of patients with early AMD, particularly when interventional trials are planned.
研究早期年龄相关性黄斑变性（早期AMD：伴有或不伴有视网膜色素上皮改变的玻璃膜疣）且视力正常的眼睛黄斑功能的不同方面，全面评估早期AMD黄斑功能损害情况，并研究黄斑功能与早期AMD眼底体征之间的关系。
对47例至少一只眼视力优于20/25的早期AMD患者进行研究：34例患者双眼患有早期AMD（第1组），13例对侧（非研究）眼患有新生血管性AMD（第2组）。36名年龄匹配的健康受试者作为对照。拍摄30度立体眼底照片和进行荧光素血管造影以对黄斑病变进行分级。采用黄斑恢复功能、中心视野敏感度、时空对比敏感度以及Farnsworth-Munsell 100色调试验来研究黄斑功能的不同方面。
与对照组相比，早期AMD患者眼中除色觉外，所有黄斑功能测试均有明显损害。第1组和第2组之间未发现功能差异。玻璃膜疣数量增加对黄斑恢复功能有负面影响。玻璃膜疣融合程度增加会降低黄斑恢复功能以及中心视野敏感度和时空对比敏感度的一些选定空间频率。视网膜色素上皮的地图样萎缩和局灶性色素沉着会降低黄斑恢复功能和最高空间频率下的对比敏感度。
黄斑恢复功能、中心视野敏感度及时空对比敏感度是早期AMD黄斑功能损害的充分且可靠指标。黄斑恢复功能是最能反映早期AMD眼底特征的测试，因为其恶化与典型眼底病变的加重平行。功能测试在早期AMD患者的评估中很有价值，尤其是在计划进行干预试验时。
