特发性黄斑前膜眼黄斑光敏度的激光扫描检眼镜微视野检测

Macular light sensibility in idiopathic epiretinal membrane measured by scanning laser ophthalmoscope

目的观察激光扫描检眼镜(SLO)黄斑光敏度检查在评估特发性黄斑前膜眼视功能中的作用以及黄斑光敏度与中心视力、黄斑中心凹厚度的相互关系。方法用SLO的微视野(microperimetry)程序对直接检眼镜、前置镜以及光相干断层扫描(OCT)检查确诊的特发性黄斑前膜患者44例55只患眼进行黄斑中心10°视野光敏度检测,并与同期同样方法检测的31只正常眼进行对比,观察特发性黄斑前膜眼黄斑光敏度变化与OCT测量的中心凹厚度及对数视力检查结果的相互关系。结果特发性黄斑前膜眼黄斑光敏度较正常对照眼下降,其差异有统计学意义(F=47.265,P<0.01)。平均光敏感度下降与视力下降呈正相关性(r=0.687,P=0.000);与黄斑中心凹视网膜厚度的增加呈负相关性(r=-0.532,P=0.003)。有视物变形眼较无视物变形眼的黄斑光敏度下降,差异有统计学意义(t=7.039,P=0.000);增生性前膜眼较水肿性前膜眼平均黄斑光敏度均下降,但差异无统计学意义(t=-1.706,P=0.094)。结论SLO的微视野程序能敏感的反映特发性黄斑前膜眼的黄斑视功能状况,定量评价黄斑光敏度的变化;黄斑光敏度变化与中心视力、黄斑中心凹厚度相关。

Objective To observe the effect of scanning laser ophthalmoscope （SLO） measuring macular light sensibility on evaluating the visual function in idiopathic epiretinal membrane （IERM）, and analyze the relationship among the macular light sensibility, central visual acuity, and the thickness of fovea. Methods Procedure of microperimetry of SLO was performed on 44 patients （55 eyes） with IERM diagnosed by indirect and direct ophthalmoscope and optical coherence tomography （OCT）. The light sensibility at 10° macular central area was measured. The results were compared with 31 healthy control eyes which underwent the same examinations simutaneously. The correlation among the macular light sensibility, the thickness of fovea measured by OCT, and the results of logarithm visual acuity was anaylzed. Results Compared with the control eyes, macular light sensibility decreased in IERM eyes significantly （F= 47.265,P〈0.01）, which had the positive correlation with the decrease of visual acuity （r= 0. 687, P= 0. 000） and negative correlation with the retinal thickness of macular fovea （r=- 0. 532,P = 0. 003）. The mean macular light sensitivity in patients with metamorphopsia decreased obviously compared with which in patients without （t=7. 039, P=0. 000）. The mean macular light sensitivity in patients with prolifertive IERM decreased compared with which in patients with dropsical IERM without statistical difference （t =- 1. 706, P = 0. 094）. Conclusion Microperimetry of SLO may sensitively reflect the macular visual function of eyes with IERM and quantificationally evaluate the changes of macular light sensibility. The changes of macular light sensitivity correlates with the central visual acuity and retinal thickness of macular fovea.