RETINAL FIXATION IMPAIRMENT IN DIABETIC MACULAR EDEMA
RETINAL FIXATION IMPAIRMENT IN DIABETIC MACULAR EDEMA
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DOI：
10.1097/iae.0b013e318183571e
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Midena, Edoardo
中科院分区：
文献类型：
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作者：
Vujosevic, Stela;Pilotto, Elisabetta;Midena, Edoardo
目的：方法：对98例（179眼）未经治疗的糖尿病性黄斑水肿患者进行最佳矫正视力测定（早期治疗糖尿病视网膜病变研究表）、数字化彩色立体眼底照相、荧光素血管造影和光学相干断层扫描（OCT）检查。用自动微视野计测定注视阈值和视网膜阈值。结果：最佳矫正视力（近似Snellen当量）为：≥ 20/25者90眼（52%），20/50 ~ 20/32者39眼（22.5%），20/200 ~ 20/62.5者35眼（20.2%），20/200以下者9眼（5.2%）。固位居中128眼（71.51%），居中较差26眼（14.53%），偏心为主25眼（13.97%），稳定133眼（74.3%），较不稳定42眼（23.46%），不稳定4眼（2.23%）。水肿特征（弥漫性、局灶性、囊样、海绵样、伴或不伴中心凹下神经视网膜脱离）对固定位置和稳定性无显著影响（P > 0.05），而中心凹下硬性渗出物的存在对固定位置和稳定性有显著影响（分别为P = 0.004和P = 0.0046）。固定部位与固定稳定性显著相关（P < 0.0001）。24眼（47%）中心固视不良，主要是偏心固视，29眼（63%）相对不稳定和不稳定fixation.Conclusion：微视野检查显示，糖尿病黄斑水肿患者的固定位置和稳定性是独立的水肿特征，除了当中心凹下硬渗出物存在。假中心凹的位置可能影响治疗策略。
Purpose: To evaluate the characteristics of retinal fixation in patients with diabetic macular edema using microperimetry.Methods: One hundred seventy nine eyes (98 patients) with untreated diabetic macular edema underwent best corrected visual acuity determination (Early Treatment Diabetic Retinopathy Study charts), digital color stereoscopic fundus photos, fluorescein angiography and Optical Coherence Tomography assessment of macula. Fixation and retinal thresholds were determined with an automatic microperimeter.Results: Best corrected visual acuity (approximate Snellen equivalent) was: 20/25 or better in 90 (52%) eyes, 20/50 to 20/32 in 39 (22.5%) eyes, 20/200 to 20/62.5 in 35 (20.2%) eyes and inferior to 20/200 in 9 (5.2%) eyes. Fixation was central in 128(71.51%), poor central in 26(14.53%) and predominantly eccentric in 25(13.97%) eyes; stable in 133(74.3%), relatively unstable in 42(23.46%) and unstable in 4(2.23%) eyes. Both fixation location and stability were not significantly influenced by edema characteristics (diffuse, focal, cystoid, spongelike, with or without subfoveal neuroretinal detachment), (P > 0.05), whereas they were significantly influenced by the presence of subfoveal hard exudates, (P = 0.004 and P = 0.0046, respectively). Site and stability of fixation were significantly associated, (P < 0.0001). Retinal pseudofovea would have been covered by laser photocoagulation in 24(47%) eyes with poorly central and predominantly eccentric fixation and in 29(63%) eyes with relatively unstable and unstable fixation.Conclusion: Microperimetry shows that fixation location and stability in patients with diabetic macular edema are independent of edema characteristics, except when subfoveal hard exudates are present. Location of pseudofovea may influence treatment strategy.