老年黄斑变性视功能损害的多因素研究

Analysis of multiple factors involved in the damage to visual function inage related macular degeneration patients

目的用黄斑区密集点矩阵视野（ＤＭＭＭ）结合计算机眼底图像分析老年黄斑变性（ＡＭＤ）视野光敏感度与眼底改变、视力、年龄、早期或晚期病变多因素，探讨视功能损害原理。方法用Ｈｕｍｐｈｒｅｙ６４０视野计设计ＤＭＭＭ，检测干性组５５眼，湿性组２７眼，计算机图像分析仪测量眼底彩色相片和荧光造影（ＦＦＡ）病变面积，进行多因素逐步回归分析。结果眼底彩色照片或ＦＦＡ病变总面积、视力、病变早或晚期分别与视野总丢失量之间的统计学检验，Ｐ＜０．０００１；年龄和视野总丢失量之间Ｐ＝０．１１６。视野总丢失量与多因素逐步回归分析显示ＦＦＡ病变面积标准化偏回归系数０．１７３９，眼底病变面积０．３３６３，视力０．３８７９。结论证实玻璃膜疣早期反映了视网膜色素上皮（ＲＰＥ）功能，早期色素上皮损害可导致视功能下降。

ObjectiveTo study the causes of damage to visual function.MethodsDense matrix mapping in the macula(DMMM) was performed by using Humphrey 640.The study included 55 macular degeneration eyes of the dry type,and 27eyes of wet tpye.The area of patients’ macular focus obtained from colour photographs and fluorescence fundus angiography(FFA) photographs was analysed by using Image Analysis Division.On the basis of linear correlation analysis,the multiple factor analysis was carried out.ResultsThere were high degree statistically significant correlations,found between total losses and total area of focuses tested in colour and FFA photographs,and visual acuity,and early stage or late stage ( P <0.0001).There were statistically significant correlations between total losses and the visual acuity ( P =0.116).The Beta of fundus focus obtained by FFA is 0.1739,fundus focus obtained by colour photographs 0.3363,visual acuity 0.3879.ConclusionThe results show a close relationship between drusens and retinal pigment epithelium(RPE).In the early stage,the changes of RPE as well as drusens can decrease visual functions.