湿性年龄相关性黄斑变性患者的视功能研究

Visual function in patients with wet age-related macular degeneration

目的探讨湿性年龄相关性黄斑变性(AMD)患者视功能的改变情况。方法利用MP-1微视野计对湿性AMD患者进行微视野检查,检测患眼的固视状态及视网膜光敏度,并分析病变性质与视网膜光敏感度的关系。结果31例患者的39眼湿性AMD接受了微视野检查,发现大部分患眼已形成旁中心注视,并且固视稳定性发生改变。黄斑区20°范围的平均视网膜光敏度下降,不同病理改变区域视网膜光敏感度不同,典型与隐匿性脉络膜新生血管(CNV)之间、出血与浆液性色素上皮脱离(PED)之间的视网膜光敏度差异均无统计学意义(P>0.05);其余各种不同病变之间视网膜光敏度均有显著性差异(P<0.05或P<0.01)。结论湿性AMD患者的视功能较差,固视稳定性下降,旁中心固视形成,治疗此类患者时应尽可能保留其残余视功能,延长其有用视力的使用时间。

Objective To investigate the visual function in patients with wet age-related macular degeneration （AMD）. Methods Microperimetry was performed on patients with wet AMD for fixation type and retinal sensitivity examination. The relationship between retinal sensitivity and pathological changes was analyzed. Results Microperimetry was performed on 39 eyes of 31 patients with wet AMD. Eccentric fixation had been developed in most of the eyes with changed fixation stability. The mean threshold value of retinal sensitivity within 20 degree of macular area was decreased and varied among different pathological regions. There were no significant differences in retinal sensitivity between classic and occult choroidal neovascularization （CNV） , and between hemorrhage and serous detachment area （ P 〉 0. 05 ）. However, there were significant differences in retinal sensitivity among the other abnormalities （ P 〈 0. 05 or P 〈 0. 01 ）. Conclusion Patients with wet AMD have relatively poorer visual function, declined stability of fixation and established eccentric fixation. The remaining visual function should be rescued and usage of usable vision be prolonged in the treatment of these patients.