Horiguchi M, Ito Y, Miyake Y
Department of Ophthalmology, Nagoya University School of Medicine, Japan.
Br J Ophthalmol. 1998 Sep;82(9):1007-12. doi: 10.1136/bjo.82.9.1007.
BACKGROUND/AIMS: A photostress recovery test was designed to differentiate macular diseases from optic nerve disorders, but recently an abnormal recovery time was reported in glaucoma. The purpose of this study was to search for the difference in abnormality of the photostress recovery test between glaucoma and idiopathic central serous chorioretinopathy (ICSC).
This study involved 21 normal subjects, 14 patients, with ICSC and 10 patients with primary open angle glaucoma (POAG). A scanning laser ophthalmoscope (SLO) was used with microperimetry for bleaching the test point and measuring the recovery of sensitivity. Photostress recovery time (SLO-PSRT) could be measured at extrafoveal points outside and inside the affected area. The initial sensitivity change and the time constant of recovery after bleaching were calculated by fitting an exponential equation to the data.
In normal subjects, neither the initial sensitivity change nor the time constant were correlated with the location of the test point. In 14 patients with ICSC, the initial sensitivity change in the detached area was significantly smaller than that in the unaffected area which was not significantly different from that in the age matched normal subjects. The time constant in the detached area was significantly longer than that in the unaffected area, which was not significantly different from that in the normal subjects. In 10 patients with POAG, the initial sensitivity change inside and outside the scotoma was not significantly different from that of age matched normal subjects. The time constant inside the scotoma was significantly longer than that outside the scotoma, which was not significantly different from that of the age matched normal subjects.
Both ICSC and POAG showed a prolonged time constant of recovery, but the initial sensitivity change was reduced only in ICSC. The difference in our results between ICSC and POAG may be caused by the difference of the retinal pathology. Further, the SLO-PSRT is very useful when the lesion is located outside the fovea.
背景/目的：光应激恢复试验旨在区分黄斑疾病与视神经疾病，但最近有报道称青光眼患者的恢复时间异常。本研究的目的是探寻青光眼与特发性中心性浆液性脉络膜视网膜病变（ICSC）在光应激恢复试验异常方面的差异。
本研究纳入21名正常受试者、14例ICSC患者和10例原发性开角型青光眼（POAG）患者。使用扫描激光检眼镜（SLO）结合微视野计对测试点进行漂白并测量敏感度恢复情况。可在患区内外的黄斑外点测量光应激恢复时间（SLO - PSRT）。通过将指数方程拟合到数据来计算漂白后的初始敏感度变化和恢复时间常数。
在正常受试者中，初始敏感度变化和时间常数均与测试点位置无关。在14例ICSC患者中，脱离区的初始敏感度变化明显小于未受影响区，未受影响区与年龄匹配的正常受试者无显著差异。脱离区的时间常数明显长于未受影响区，未受影响区与正常受试者无显著差异。在10例POAG患者中，暗点内外的初始敏感度变化与年龄匹配的正常受试者无显著差异。暗点内的时间常数明显长于暗点外，暗点外与年龄匹配的正常受试者无显著差异。
ICSC和POAG均显示恢复时间常数延长，但仅ICSC的初始敏感度变化降低。ICSC和POAG结果的差异可能由视网膜病理差异引起。此外，当病变位于黄斑外时，SLO - PSRT非常有用。
