摘要
目的研究频域光学相干断层扫描(SD-OCT)检查黄斑区外层视网膜结构对视网膜色素变性(RP)患者5年后视力的预测价值。方法选择随访5年及以上的RP患者70例111只眼,将初诊时最佳矫正视力(BCVA)属轻度或无视力损伤(BCVA≥0.3)分为A组(n=66),中度及以上视力损伤(BCVA<0.3)分为B组(n=45),记录比较2组患眼的一般资料,观察RP患者视力进展;采用SD-OCT检查2组患眼初诊时的黄斑区视网膜外层结构-外核层(ONL)、外界膜(ELM)、椭圆体带(EZ)、嵌合体带(IZ)、视网膜色素上皮/Bruch膜复合体(RPE/Bruch)及外层视网膜剩余层数,Spearman相关分析外层结构与末次随访视力的相关性,多元线性回归模型寻找末次随访视力的预测因子。结果随着患者年龄的增长,BCVA<0.3的患眼比例不断增加;在A组中,ONL、ELM、EZ、IZ、RPE/Bruch的缺失以及更少的外层视网膜剩余层数与更差的随访BCVA相关(r_(s)=-0.622,-0.704,-0.685,-0.282,-0.447,-0.676,P<0.05),ONL的缺失是随访BCVA更差的独立预测因子(R^(2)=0.54,t=-6.49,P<0.001);在B组中,ELM、EZ、RPE/Bruch的缺失及外层视网膜剩余层数较少与更差的随访BCVA显著相关(r_(s)=-0.352、-0.351、-0.339、-0.408;P=0.018、0.018、0.023、0.005)。结论利用SD-OCT检查黄斑区视网膜外层结构对BCVA≥0.3的RP患眼5年后的视力有一定的预测价值。
Objective To investigate the predictive value of spectral-domain optical coherence tomography(SD-OCT)examination of the outer_(s)tructure of retina in macular areas for visual acuity in patients with retinitis pigmentosa(RP)after 5 years.Methods Seventy patients(111 eyes)with RP patients who were followed up for 5 years or more were selected.The patients were divided into two groups based on best-corrected visual acuity(BCVA)at the first visit:group A(BCVA≥0.3,mild or no visual impairment,n=66)and group B(BCVA<0.3,moderate or above visual impairment,n=45).General information of the two groups of affected eyes was recorded and compared,and the visual progress of RP patients was observed.SD-OCT was performed to examine the outer_(s)tructure of the retina in macular areas of two groups at the first diagnosis,including outer nuclear layer(ONL),outer membrane(ELM),elliptical zone(EZ),chimeric zone(IZ),retinal pigment epithelium-Bruch's membrane complex(RPE/Bruch)and the remaining layers of the outer retina.Spearman correlation was used to analyse the correlation between outer_(s)tructure and last follow-up visual acuity.Multivariable linear regression model was used to search for predictive factors at last follow-up visual acuity.Results With the patients'age increase,the proportion of eyes with BCVA<0.3 constantly increased.In group A,the losses of ONL,ELM,EZ,IZ,RPE/Bruce,and few remaining layers of the outer retina were associated with worse follow-up BCVA(r_(s)=-0.622,-0.704,-0.685,-0.282,-0.447,-0.676,respectively;P<0.05).The absence of ONL was an independent predictor for poor follow-up BCVA(R^(2)=0.54,t=-6.49,P<0.001).In group B,the losses of ELM,EZ,RPE/Bruce,and few remaining layers of the outer retina were associated with worse follow-up BCVA(r_(s)=-0.352,-0.351,-0.339,-0.408,respectively;P=0.018,0.018,0.023,and 0.005,respectively).Conclusion SD-OCT examination for the outer_(s)tructure of the retina in the macular areas has certain predictive value for the visual acuity of RP patients with BCVA≥0.3 after
作者
朱黎
张敏芳
赵同涛
陈旭
谢晶
余涛
阴正勤
ZHU Li;ZHANG Minfang;ZHAO Tongtao;CHEN Xu;XIE Jing;YU Tao;YIN Zhengqin(Department of Ophthalmology,the First Affiliated Hospital of the Army Medical University Chongqing 400038,Chongqing,China)
出处
《贵州医科大学学报》
CAS
2023年第9期1059-1065,共7页
Journal of Guizhou Medical University
基金
国家自然科学基金(82000921)。
关键词
视网膜色素变性
视网膜外层结构
频域光学相干断层扫描
外核层
视网膜色素上皮层
最佳矫正视力
纵向研究
retinitis pigmentosa
outer structure of the retina
spectral-domain optical coherence tomography
outer nuclear layer
retinal pigment epithelium
best-corrected visual acuity
longitudinal study
