Incidence of idiopathic full-thickness macular holes in fellow eyes -: A 5-year prospective natural history study
Incidence of idiopathic full-thickness macular holes in fellow eyes -: A 5-year prospective natural history study
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DOI：
10.1016/s0161-6420(98)93562-x
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发表时间：
1998-02-01
期刊：
影响因子：
13.7
通讯作者：
Gregor, ZJ
中科院分区：
文献类型：
--
作者：
Ezra, E;Wells, JA;Gregor, ZJ
目的：探讨特发性全层黄斑裂孔(FTMH)在正常对侧眼中的发生率，并评价电诊断和心理物理检查在鉴别高危眼病中的作用。受试者分别于18个月和5年进行基线检查、模式反转视网膜电图、眼电(EGG)和颜色对比敏感度(CCS)检测Protan、Deutan和Tritan阈值并进行临床检查。结果：基线检查114例患者。在18个月时，有80人可以复查，其中6人在对侧眼出现了全层黄斑裂孔。5年后，对其余74名18个月后仍未出现孔洞的患者中的67名进行了复查，另有5名患者的另一只眼出现了孔洞。5岁时20只眼发生玻璃体后脱离，无孔洞形成。尽管基线时患眼和对侧眼的平均模式翻转视网膜电图仪和眼电地形图反应均在正常范围内，但患眼的平均CCSProtan、Deutan和Tritan阈值在基线时显著升高(P=0.0001)。未受影响的对侧眼显示平均Protan和Deutan阈值正常，但在基线时平均Tritan阈值显著升高(P=0.01)。结论：Kaplan-Meier估计5年后对侧眼受累的风险为15.6%(8.4%-22.3%；P=0.05)。虽然电诊断和心理物理测试不能预测对侧眼的受累，但在看似正常的对侧眼，基础状态下的CCS丢失可能表明亚临床中心凹功能障碍，其性质尚不清楚。
Purpose: This study aimed to determine the incidence of idiopathic full-thickness macular hole (FTMH) in normal fellow eyes and to evaluate the role of electrodiagnostic and psychophysical tests in identifying eyes at risk.Patients and Methods: A prospective longitudinal natural history study of a cohort of patients with unilateral holes and normal, asymptomatic fellow eyes without posterior vitreous detachment was conducted. Subjects underwent baseline examination, pattern reversal electroretinography, electro-oculography (EGG), and color contrast sensitivity (CCS) testing for protan, deutan, and tritan thresholds and were recalled for clinical examination at 18 months and 5 years.Results: At baseline, 114 patients were examined. Eighty were available for review at 18 months, of whom 6 had full-thickness macular holes develop in the fellow eye. At 5 years, 67 of the remaining 74 patients who had not developed holes at 18 months were re-examined and a further 5 were found to have holes develop in the fellow eye. A posterior vitreous detachment without hole formation had developed in 20 fellow eyes at 5 years. Although mean pattern reversal electroretinography and EOG responses were within normal limits in affected and fellow eyes at baseline, mean CCS protan, deutan, and tritan thresholds were elevated significantly in affected eyes at baseline (P = 0.0001). Unaffected fellow eyes showed normal mean protan and deutan thresholds, but significantly elevated mean tritan thresholds (P = 0.01) at baseline. Mean tritan CCS loss was, however, similar in fellow eyes in which holes later developed and in fellow eyes in which holes did not.Conclusions: The Kaplan-Meier estimated risk of fellow eye involvement is 15.6% (range, 8.4%-22.3%; P = 0.05) at 5 years. Although electrodiagnostic and psychophysical testing was not predictive of fellow eye involvement, tritan CCS loss at baseline, in apparently normal fellow eyes, may indicate subclinical foveal dysfunction, the nature of which is unclear.