病理性近视患者黄斑功能的微视野检查

Macular function of pathologic myopic retina evaluated by microperimetry

目的 观察病理性近视患者黄斑功能的微视野检查表现.方法 回顾分析90例病理性近视患者142只眼的临床资料.所有患者均详细询问病史,并行最佳矫正视力（BCVA）、屈光度、眼轴、荧光素眼底血管造影（FFA）、间接检眼镜和黄斑部光相干断层扫描（OCT）检查.根据检查结果 将患者分为无黄斑病理改变和黄斑病理改变组,分别为20例24只眼、70例118只眼.采用MP-1微视野计对两组患者行眼底成像和黄斑部微视野检查,记录受检眼黄斑10°范围内视网膜平均光敏感度（MS）、固视稳定性、2°和4°固视率及固视点位置.结果 无黄斑病理改变组和黄斑病理改变组MS值分别为（16.39±2.12）、（10.80±4.53）dB,二者比较,差异有统计学意义（F=15.044,t=-9.314;P=0.000）.无黄斑病理改变组24只眼中,固视稳定19只眼,占79.2%;相对不稳定5只眼,占20.8%.黄斑病理改变组118只眼中,固视稳定45只眼,占38.1%;相对不稳定52只眼,占44.1%;不稳定21只眼,占17.8%.两组固视稳定率比较,差异有统计学意义（χ2=13.56,P=0.000）.两组2°和4°固视率比较,差异均有统计学意义（F=5.773,13.230;t=-4.110,-5.465;P值均=0.000）.无黄斑病理改变组24只眼中,中心固视23只眼,占95.8%;弱中心固视1只眼,占4.2%.黄斑病理改变组118只眼中,中心固视81只眼,占68.6%;弱中心固视16只眼,占13.6%;旁中心固视21只眼,占17.8%.两组中心固视率比较,差异有统计学意义（F=9.618,t=-5.773;P=0.000）.结论 病理性近视有黄斑病理改变者较无黄斑病理改变者MS、固视稳定性下降,并有旁中心固视点形成.

Objective To observe the microperimetry performance of macular function in pathologic myopia patients. Methods The clinical data of 90 patients （142 eyes） with pathologic myopia were retrospectively analyzed. All patients were asked in details about history, and take examinations of best corrected visual acuity （BCVA）, refractive dioptre, eye axis, fluorescent fundus angiography （FFA）,indirect ophthalmoscopy and optical coherence tomography （OCT）. According to the test results, patients were divided into non-pathological macular group （20 patients, 24 eyes） and pathological macular group （70patients, 118 eyes）. Retinal imaging and macular microperimetry were measure by MP-1 Microperimeter.The mean retinal sensitivities （MS） and fixation stability in the central 10°, fixation rate and fixation position in the central 2° and 4°were determined. Results The MS of pathological and non-pathological macular group were （16.39± 2. 12）, （10. 80± 4.53） dB respectively, the difference was statistically significant （F= 15.044, t=-9.314;P= 0. 000）. Among 24 eyes of non-pathological macular group,fixation was stable in 19 eyes （79.17%）, relative unstable in five eyes （20. 83%）;among 118 eyes of pathological macular group, fixation was stable in 45 eyes （38. 14%）, relative unstable in 52 eyes （44.07%）, unstable in 21 eyes （17.79%）, the difference was statistically significant （χ2= 13.56, P=0. 000）. The differences of 2 ° and 4 ° fixation rate between those two groups are statistically significant （F=5. 773, 13. 230;t= -4. 110, -5. 465;P= 0.000） . Among 24 eyes of non-pathological macular group, center fixation occurred in 23 eyes （95.83 % ）, weak center fixation occurred in one eye （4.17 %）;among 118 eyes of pathological macular group, fixation center occurred in 81 eyes （68. 64%）, weak center fixation occurred in 16 eyes （ 13. 56 % ）,eccentric fixation occurred in 21 eyes （ 17. 80 % ）, the difference was statistically significant （F=9. 618, t= -5. 773;P=0. 000）. Conclusion Pathological myopia patients with pathological macular changes have decreased retinal sensitivity, decreased fixation stability and eccentric fixation points.