摘要
目的观察Leber遗传性视神经病变(LHON)微视野特征,初步探讨其在LHON诊断及治疗评估中的意义。方法回顾性临床研究。2015年5月至2022年5月在陆军军医大学第一附属医院确诊的LHON患者13例25只眼(患病组)纳入研究,其中男性9例18只眼,女性4例7只眼;初诊时年龄15.0(10.0,57.0)岁。选取健康志愿者10例19只眼作为正常组,其中男性7例13只眼,女性3例6只眼;初诊时年龄22.0(6.0,46.0)岁。根据初诊时病程,将患病组患眼再分为无症状组(携带者)、亚急性组(<6个月)、动态组(6~12个月)、慢性组(>12个月),分别为7、6、5、7只眼。所有受检眼均行最佳矫正视力(BCVA)、微视野检查。BCVA检查采用国际标准视力表进行,统计时换算为最小分辨角对数(logMAR)视力。采用MP-3微视野计行微视野检查,记录受检眼中心、上方、颞侧、下方、鼻侧5个区域的平均光敏感度(MS)值。两组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis H检验。结果与正常组比较,患病组患眼中心、上方、颞侧、下方、鼻侧MS降低,差异均有统计学意义(Z=-5.629、-4.906、-5.630、-5.631、-5.227,P<0.05)。不同病程组患眼不同区域MS比较,差异均有统计学意义(H=12.296、11.583、10.110、12.994、8.663,P<0.05)。组间两两比较,无症状组与亚急性组,logMAR BCVA、中心MS差异有统计学意义(P=0.040、0.007);亚急性组与动态组,颞侧、下方、上方MS差异有统计学意义(P=0.026、0.017、0.018);动态组与慢性组,上方MS差异有统计学意义(P=0.031)。23只眼中,4只眼接受艾地苯醌治疗后视野缺损较治疗前明显好转。结论LHON患者早期中心视野缺损,逐渐向颞侧、下方、上方进展,以颞侧、下方为重;病程6~12个月时视野缺损达到稳定水平。MP-3微视野计可以协助早期诊断LHON,并为疗效评估提供可靠依据。
Objective To observe Leber's hereditary optic neuropathy(LHON)microperimetry features,discuss its significance in diagnosis and treatment of LHON assessment.Methods A retrospective clinical study.A total of 13 LHON patients(25 eyes)diagnosed in Department of Ophthalmology of the First Affiliated Hospital of Army Medical University from May 2015 to May 2020(disease group)were included in the study,including 9 males(18 eyes)and 4 females(7 eyes),and beginning with the age of 15.0(10.0,57.0).Ten healthy volunteers(19 eyes)were selected as the normal group,including 7 males(13 eyes)and 3 females(6 eyes),aged 22.0(6.0,46.0)years at the first diagnosis.According to the course is divided into:asymptomatic group(carriers),subacute(<6 months),the dynamic group(6-12 months),chronic group(>12 months).There were 7,6,5 and 7 eyes,respectively.All eyes underwent best corrected visual acuity(BCVA)and microperimetry.BCVA test was performed using the international standard visual acuity chart,which was statistically converted to the logarithm of the minimum Angle of resolution(logMAR)visual acuity.MP-3 microperimetry was used to perform microperimetry,and the mean sensitivity(MS)values of five regions were recorded:center,superior,temporal,inferior,and nasal.Mann-Whitney U test was used for comparison between two groups,and Kruskal-Wallis H test was used for comparison between multiple groups.Results Compared with the normal group,MS in the center,superior,temporal,inferior and nasal of the diseased group decreased,and the differences were statistically significant(Z=-5.629,-4.906,-5.630,-5.631,-5.227;P<0.05).There were significant differences in different regions of MS between different course groups(H=12.296,11.583,10.110,12.994,8.663;P<0.05).There were significant differences in logMAR BCVA and central MS between asymptomatic group and subacute group(P=0.040,0.007).There were significant differences in temporal,inferior and superior MS between subacute group and dynamic group(P=0.026,0.017,0.018).Dynamic and chronic group,MS a
作者
何欣耘
关海东
李自杨
黄小勇
He Xinyun;Guan Haidong;Li Ziyang;Huang Xiaoyong(Department of Ophthalmology,The First Affiliated Hospital,Army Medical University,Chongqing 400038,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2024年第7期506-511,共6页
Chinese Journal of Ocular Fundus Diseases
