渗出性老年黄斑变性视力性质分析

The visual characteristic analysis of exudative age-related macular degeneration patients

目的 用直接检眼镜、光相干断层扫描（OCT）,对渗出型老年性黄斑变性患眼的视力性质进行分析.方法 临床病例系列研究.对2012年2月至2013年1月,就诊于沈阳市第四人民医院眼科门诊经眼底荧光素造影（FFA）确诊的32例渗出型老年性黄斑病变性患者34只眼,用直接检眼镜小光斑判断患眼的注视点位置和黄斑中心凹的视觉功能,OCT对注视点和视网膜病变进行检查.结果 24只眼出现中心外固视,其中注视稳定者16只眼,注视不稳定者8只眼;10只眼为中心固视.中心固视患者平均视力（对数视力）为（4.59＋0.11）,要好于中心外注视患者视力（4.20＋0.18）.中心外固视且注视稳定眼,视力与固视点到黄斑中心凹的距离呈负相关关系（r=-0.686,P=0.003）.中心视力眼与黄斑中心凹的增厚程度呈负相关关系（r=-0.693,P=0.02）.中心外固视患者注视点可位于健康的视网膜,也可位于病变的视网膜.结论 由于渗出型老年性黄斑变性患者的中心视力受损,使其视力易受固视点位置的影响,而出现中心外固视,影响视功能.

Objective To analyze the visual characteristic of exudative age-related macular degeneration patients by the optical coherence tomography （OCT）,direct ophthalmoscope.Methods Selected 34 eyes （32 patients） which were diagnosed as exudative age-related macular degeneration by FFA.The position of fixation and the function of the fovea were evaluated by direct ophthalmoscope.OCT was used to examine the retinopathy and the fixation.Results Of 24 eyes had eccentric fixation,10 eyes had central fixation.On 24 eccentric fixation eyes：16 had stable fixation,8had unstable fixation.The visual acuity of eyes with central fixation was better than eyes with eccentric fixation.In the eyes with stable and eccentric fixation,negative correlation was found between visual acuity and the distance between the position of fixation and fovea.In the eyes with central fixation,negative correlation was found between visual acuity and retinal thickness in fovea.In the eyes with central fixation,the position of fixation could be found on healthy retina or unhealthy retina.Conclusions The eccentric fixation is found in the eyes with exudative age-related macular degeneration.The visual acuity is influenced by the position of fixation and focus of infection.