频域光学相干断层扫描在原发性视网膜色素变性中的应用

目的:应用频域光学相干断层扫描对原发性视网膜色素变性(retinitis pigmentosa,RP)患者进行图像分析,并评价其与视力敏感度的相关性。方法:对15例30眼RP患者和20例40眼正常人进行频域光学相干断层扫描,RP病例选择依靠病史、眼前后节检查、眼底荧光血管造影及电生理检查,所有病例均进行全层、内层及外层视网膜厚度的测量。正常组与RP组之间的视网膜厚度比较采用独立样本t检验,视网膜厚度与视力敏感度的相关性采用Pearson检验。结果:所有RP患者的光感受器层均变薄,正常组与RP患者的内层视网膜厚度变化无统计学意义,而全层及外层视网膜厚度变化有统计学意义。视力敏感度与全层视网膜厚度有较好的相关性,与外层视网膜厚度有更好的相关性。结论:应用频域光学相干断层扫描可以进行外层视网膜厚度的测量,而外层视网膜厚度可以对光感受器的丢失进行更好的评价,RP患者的外层视网膜厚度显著变薄,且与视力敏感度呈相关性。

Application of frequency domain optical coherence tomography in retinitis pigmentosa patients

AIM: To assess photoreceptor morphology in patients with retinitis pigmentosa(RP) using frequency domain optical coherence tomography (FD-OCT)and its correlation with visual acuity (VA). METHODS: Thirty eyes of 15 patients with RP were imaged with FD-OCT . Patients were selected based on history, examination, fluorescein angiography, and electroretino-graphy. Concurrently, 40 eyes of 20 normal subjects were imaged with FD-OCT. Total retinal thickness (RT),inner retinal layer (IRL) and outer retinal layer (ORL) were defined and measured on FD-OCT images in all subjects and were compared between the two groups using independent-sample t test. The RT and ORL thickness measurements in RP patients were correlated with visual acuity using Pearson correlation and linear regression. RESULTS:FD-OCT demonstrated macular photoreceptor thinning in all RP patients. The difference in IRL between RP patients and normal subjects was not statistically significant (P=0.058), but the difference in RT and ORL between the two groups was significant (P<0.01). Visual acuity showed a fair correlation with RT and an excellent correlation with ORL . CONCLUSION :In the current study using FD-OCT, a new thickness measurement termed ORL is demonstrated to quantify photoreceptor loss. ORL was statistically thinner in patients with RP than in normal eyes and showed correlation with logMAR visual acuity. ORL appears to be a probable predictor of visual acuity in RP.