新生血管性年龄相关性黄斑变性的高阶像差分析

Ocular Higher-order Aberrations in Patients with Neovascular Age-related Macular Degeneration

目的通过与对侧眼进行比较,了解新生血管性年龄相关性黄斑变性(neovascular age-relatedmacular degeneration,nAMD)患眼高阶像差分布特征,并探讨nAMD眼高阶像差与视力的关系。方法使用美国Bausch&Lomb公司的ZywaveⅡ像差分析仪对32例确诊单眼nAMD的患者进行双眼像差检查,对检查结果中的6mm瞳孔下的Zernike多项式的像差均方根值(RMS)进行统计,比较nAMD眼与对侧眼的高阶像差分布,对nAMD眼像差RMS值与最佳矫正视力对数值(LogMAR)视力进行相关分析。结果 nAMD眼与对侧眼相比,总高阶像差(HOAs)、三阶像差(RMS3)、球差(SA)、彗差(Coma)、水平彗差(Coma along x axis)、水平三叶草(Horizontal trefoil)的差异有统计学意义(P<0.05),nAMD眼高于对侧眼。慧差和垂直三叶草(Vertical trefoil)与LogMAR视力存在正相关关系(rs=0.377,P=0.034;rs=0.416,P=0.018)。结论 nAMD眼的高阶像差较对侧眼增加,增大的高阶像差可能对远矫正视力产生影响。在nAMD视功能评估中,应加入高阶像差的评估。

Objective To evaluate changes in higher-order aberrations of eyes in patients with unilateral neovascular age-related macular degeneration （nAMD）. Methods Thirty two patients with unilateral nAMD were recruited for this study. Biocular higher-order wavefront aberrations for a 6-mm pupil were measured with Zywave Ⅱ aberrometer （Bausch ＆ Lomb,Zyoptix, USA）. The root mean square （RMS） of Zernike coefficients were compared between the eyes with nAMD and the fellow eyes. Relation ship between RMS values and LogMAR vision of the nAMD were analysed. Results The total higher-order aberrations （HOAs）, third order aberrations （RMS3）, sphere aberration （SA）, coma, coma along x axis, and horizontal trefoil in the eyes with nAMD were all significantly greater than those in the fellow eyes （P^0.05）. Increases of vertical trefoil and coma were found to be associated with increased LogMAR values （rs=0. 377, P=0. 034; rs=0. 416, P=0. 018）. Conclusion Higher- Order aberrations in nAMD are greater than normal eyes, which may have effects on distant corrected visual acuity. Examinations of higher-order aberrations should be added into visual function evaluations of nAMD.