黄斑水肿的微视野评估与视力的相关性研究

目的：分析不同疾病引起的黄斑水肿患者微视野检查与视力的相关性。

方法：纳入黄斑水肿患者127例164眼，其中年龄相关性黄斑病变(ARMD)38例38眼，视网膜静脉阻塞(RVO)43例43眼，糖尿病性黄斑水肿(DME)46例83眼。所有患者均行最佳矫正视力(BCVA)，光学相干断层扫描仪(OCT)及黄斑微视野检查，并进行统计学分析。

结果：黄斑水肿患者的总体视网膜平均敏感度(MS)、固视率(P1，P2)与BCVA呈正相关，而黄斑视网膜厚度(CRT)与BCVA呈负相关。ARMD组MS与BCVA呈正相关，而固视率及CRT与BCVA不相关； DME组和视网膜中央静脉阻塞(CRVO)组中MS及P1，P2与BCVA均呈正相关，DME组CRT与BCVA呈负相关，CRVO组CRT则与BCVA不相关； 视网膜分支静脉阻塞(BRVO)组MS和CRT与BCVA均不具相关性。

结论：微视野检查对ARMD患者的评估可能比OCT更能反映黄斑功能的变化，在CRVO及DME的患者中微视野作为主观评价指标与OCT有协同作用，而在BRVO患者中微视野的评价仍需进一步研究。

The correlation between visual acuity and microperimetry evaluation of macular edema

AIM: To analyze the correlation between subjective mean sensitivity and visual function via macular microperimetry.

METHODS: Totally 164 eyes of 127 patients with macular edema were involved in this study. According to different diseases, they were divided into 3 groups: age-related macular degeneration(AMD)(38 eyes), retinal vein occlusion(RVO)(43 eyes)and diabetic macular edema(83 eyes)groops. All patients underwent the examinations of optometry, optical coherence tomography scanner(OCT)and microperimeter. Correlation analysis was performed using Pearson, and t-test among groups.

RESULTS: Mean sensitivity(MS)values and fixation rate(P1, P2)of total patients with macular edema were significantly correlated with their BCVA, meanwhile the CRT was negatively correlated. MS values were significantly correlated with BCVA in AMD group, but the P1, P2 and CRT were not correlated. In DME and CRVO groups, MS values and P1, P2 were significantly correlated with BCVA, and CRTs were negatively correlated in DME but not correlated in CRVO. In BRVO group, MS values and CRTs were all not correlated with BCVA.

CONCLUSION:Microperimetry is probably a better subjective assessment for AMD macular function than OCT, and could be combined with OCT for function follow-up in DME and CRVO patients. For BRVO microperimetry might indicate certain macular dysfunction that could not be detected by VA or CCT. Microperimetry could be a subjective examination for the assessment of macular edema combined with OCT.