视网膜色素变性患者黄斑区微视野检测参数与视网膜结构的相关性分析

Correlation of microperimetric parameters with retinal structure in patients with retinitis pigmentosa

目的通过对原发性视网膜色素变性(retinitis pigmentosa,RP)患者进行黄斑区的微视野及光谱域光学相干断层扫描(SD-OCT)检查,探讨微视野功能检测与视网膜结构的对应关系。方法收集2015-2017年本科诊断为RP的患者23例(46眼),进行视力、黄斑区SD-OCT、微视野检查,对最佳矫正视力、视网膜光敏感度与视网膜厚度进行相关性分析。结果微视野检测的黄斑中心10°范围内视网膜的光敏感度与SD-OCT检测的相对应区域的总视网膜厚度相关(鼻侧3°、5°分别为r=0. 462,P <0. 05; r=0. 350,P <0. 05;颞侧3°、5°分别为r=0. 494,P <0. 05; r=0. 426,P <0. 05),其中与对应区域的外层视网膜厚度显著相关(鼻侧3°、5°分别为r=0. 718,P <0. 05; r=0. 643,P <0. 05;颞侧3°、5°分别为r=0. 639,P <0. 05; r=0. 564,P <0. 05),而与对应区域的内层视网膜厚度无明显相关性,最佳矫正视力与黄斑区中心凹光视敏度显著相关(r=0. 682,P <0. 05)。结论微视野和SD-OCT相结合可有效评价RP患者黄斑区10°内的视网膜功能;微视野可作为RP病变过程中评判感光细胞功能改变的指标。

Objective To investigate the retinal function corresponding to retinal structure by microperimetry and spectral-domain optical coherence tomography( SD-OCT) for the macular area in the patients with primary retinitis pigmentosa( RP). Methods A retrospective analysis was performed among 23patients( 46 eyes) diagnosed with RP in our department from January 2015 to December 2017. The results of visual acuity,SD-OCT in the macular area and microperimetry were collected and analyzed. The correlation of best corrected visual acuity,retinal sensitivity and retinal thickness was analyzed. Results The retinal sensitivity in the range of 10° around the fovea by microperimetry was related to the total retinal thickness of the corresponding area detected by SD-OCT( nasal 3°,5°: r = 0. 462,P < 0. 05;r = 0. 350,P < 0. 05;temporal 3°,5°: r = 0. 494,P < 0. 05;r = 0. 426,P < 0. 05),and was significantly correlated with outer retinal thickness( nasal 3°,5°: r = 0. 718,P < 0. 05;r = 0. 643,P < 0. 05;temporal 3°,5°: r = 0. 639,P <0. 05;r = 0. 564,P < 0. 05),but not with inner outer retinal thickness. The best corrected visual acuity and the sensitivity of central macular was significantly correlated( r = 0. 682,P < 0. 05). Conclusion The combination of microperimetry and SD-OCT can effectively evaluate the retinal function and morphological characteristics of RP patients. The changes of microperimetric parameters are mainly related to photoreceptor cell apoptosis,which can be used as an indicator to judge photoreceptor function changes during RP lesions.