Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration
Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration
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DOI：
10.1167/iovs.12-10361
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发表时间：
2012-11-01
影响因子：
4.4
通讯作者：
Greenstein, Vivienne C.
中科院分区：
文献类型：
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作者：
Acton, Jennifer H.;Smith, R. Theodore;Greenstein, Vivienne C.
目的.采用光谱域光学相干断层扫描（SD-OCT）和微视野测量，对早期年龄相关性黄斑变性（AMD）患者的结构和功能变化进行量化和比较。对21例早期AMD受试者的21只眼进行了检查。采集MP-1 10-2视野（VF）和SD-OCT线和细节体积扫描。使用计算机辅助手动分割技术测量外段（OS;内段椭圆体带和上部视网膜色素上皮[RPE]边界之间的距离）和RPE层的厚度以及RPE从Bruch膜的高度。厚度值进行了比较，与15个控制，并在VF总偏差缺陷的位置值进行了比较，在同等偏心率的非缺陷位置的值。21只AMD眼中有16只存在VF缺陷。与对照组相比，线扫描显示OS层明显变薄（P = 0.006），RPE增厚和升高（P = 0.037，P = 0.002）。与无缺陷的位置相比，VF缺陷位置的OS层显著更薄（P = 0.003）。5只无VF缺陷的患眼视网膜层厚度与正常对照组比较差异无统计学意义。在早期AMD中，当存在VF缺陷时，OS层显著变薄，RPE增厚和升高。OS层变薄与视觉敏感度降低显著相关，与早期AMD中已知的感光细胞损失一致。对于无VF缺陷的AMD受试者，厚度值正常。结果突出了SD-OCT视网膜层定量和VF测试在早期AMD中的临床实用性。（Invest Ophthalmol维斯科学。2012; 53：7618-7624）DOI：10.1167/iovs.12-10361
PURPOSE. To quantify and compare the structural and functional changes in subjects with early age-related macular degeneration (AMD), using spectral-domain optical coherence tomography (SD-OCT) and microperimetry.METHODS. Twenty-one eyes of 21 subjects with early AMD were examined. MP-1 10-2 visual fields (VFs) and SD-OCT line and detail volume scans were acquired. The thicknesses of the outer segment (OS; distance between inner segment ellipsoid band and upper retinal pigment epithelium [RPE] border) and RPE layers and elevation of the RPE from Bruch's membrane were measured using a computer-aided manual segmentation technique. Thickness values were compared with those for 15 controls, and values at locations with VF total deviation defects were compared with values at nondefect locations at equivalent eccentricities.RESULTS. Sixteen of 21 eyes with AMD had VF defects. Compared with controls, line scans showed significant thinning of the OS layer (P = 0.006) and thickening and elevation of the RPE (P = 0.037, P = 0.002). The OS layer was significantly thinner in locations with VF defects compared with locations without defects (P = 0.003). There was a negligible difference between the retinal layer thickness values of the 5 eyes without VF defects and the values of normal controls.CONCLUSIONS. In early AMD, when VF defects were present, there was significant thinning of the OS layer and thickening and elevation of the RPE. OS layer thinning was significantly associated with decreased visual sensitivity, consistent with known photoreceptor loss in early AMD. For AMD subjects without VF defects, thickness values were normal. The results highlight the clinical utility of both SD-OCT retinal layer quantification and VF testing in early AMD. (Invest Ophthalmol Vis Sci. 2012; 53: 7618-7624) DOI:10.1167/iovs.12-10361