中医药治疗视网膜色素变性的定量视野学研究

Quantitative Visual Field Study of Retinitis Pigmentosa with TCM Treatment

采用现代静态定量视野检测技术,对中医药治疗的视网膜色素变性(RP)54例患者106只眼进行了研究。结果表明:①静态定量视野的平均敏感度(MS)在RP眼较正常对照组降低,治疗后敏感度获一定程度回升,且以中心30°视野区内的变化为显著;②各型RP眼的MS治疗后发生不同程度的改善,在脾肾阳虚型和常染色体显性遗传型RP具有统计学意义;③提出静态定量视野基础上的动态视野分析方法,发现各型RP眼的平均视野范围在治疗后发生一定程度的扩大,在常染色体显性遗传RP和小于5年病程组的患者则具有高度显著性意义(p<0.01)。从而揭示中医药治疗可在一定程度上改善RP眼视网膜不同区域的视功能,对延缓RP病情进展,保持中心视力具有特定的临床意义。

Automated static quantitative visual field and kinetic visual field were measured in 106 eyes of 54 patients affected by the different hereditary forms of retinitis pigmentosa (RP) before and after 6 months of TCM treatment, and the alteration of physiological function in the center and peripheral part of retina was investigated. The results showed that mean light sensitivity (MS) in various area of the retina decreased obviously and improved after TCM treatment, especially from fovea centralis to 30 degree. MS was improved to a certain extent not only in the patients with different hereditary modes of RP, but also in those by clinical TCM classification after the treatment. The differences of visual sensitivity from fovea centralis to 15 degree in patients with the deficiency of spleen and kidney yang and autosomal dominant RP (ADRP) were highly significant statistically (P<0. 01), and 15 degree to 30 degree were significant statistically (P<0. 05) .Amethod and formula for measuring the changes of kinetic visual field (VF) was presented to obtain function information in the retina more scientifically, accurately and conveniently than those in the previous studies. The diameter of visual field also enlarged to a certain extent, especially in ADRP and those with early retinal degeneration. The results suggest that visual function in RP patient should be improved with TCM treatment, and both MS and VF are effective indicator for the quantitative detection of visual field.