Vision test variability in retinitis pigmentosa and psychosocial factors.
Vision test variability in retinitis pigmentosa and psychosocial factors.
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DOI：
10.1097/opx.0b013e3182348d0b
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发表时间：
2011-12
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影响因子：
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通讯作者：
Dagnelie G
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文献类型：
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作者：
Bittner AK;Ibrahim MA;Haythornthwaite JA;Diener-West M;Dagnelie G
我们探讨了视网膜色素变性(RP)患者的视力(VA)、对比敏感度(CS)或视野(VF)的较大短期变异性是否与疾病严重程度或心理社会因素有关。我们对27名RP受试者进行了光谱域光学相干断层扫描，并测定了VA、CS和VF的变异性(SD)。受试者在每个PC测试阶段完成积极和消极情绪量表，并一次性完成SF-36一般健康和贝克抑郁量表问卷。每增加0.58logMAR(较差的平均VA)，VA变异性增加0.10log单位(p=0.001)。对于黄斑中心凹厚度减少的受试者，平均VA比黄斑中心凹厚度更能解释总的VA变异(在简单的线性回归中，R2分别为0.72和0.46)。对数VF面积平均每减少50%，对数VF面积变异性增加4.3%(p<；0.001)；解释了对数VF面积变异性的大部分总变异性(R2=0.44)。当控制平均对数室颤面积时，大于轻度抑郁症状的受试者的对数室颤面积变异性显著增加(p=0.015)，平均易怒分数增加(p=0.02)，SF-36身体功能分量表分数降低(p=0.03)，或感觉活跃、强壮和自豪的平均分数降低(p=0.008)(调整后的R2=0.62)。CS变异性很低，与平均CS、黄斑厚度或心理社会因素无统计学意义相关。VA和VF变异性的增加在很大程度上可以通过RP严重程度的增加来预测。更大的室颤变异性发生在室颤减少的受试者，他们报告较少的体力活动或增加的负面心理社会状态。在RP的临床检查和试验中应考虑这些相关性。
We explored whether greater amounts of short-term variability in visual acuity (VA), contrast sensitivity (CS), or visual field (VF) in retinitis pigmentosa (RP) was related to disease severity or psychosocial factors. We obtained spectral domain-optical coherence tomography in 27 RP subjects and determined variability (SD) of VA, CS and VF during a mean of 16 tests self-administered at home on a personal computer (PC) twice a week. Subjects completed the Positive and Negative Affect Schedules at each PC-test session, and SF-36 general health and Beck Depression Inventory questionnaires on one occasion. There was a 0.10 log unit increase in VA variability for every 0.58 logMAR increase (worse mean VA) (p=0.001). For subjects with reduced foveal thickness, mean VA explained more of the total VA variability than foveal thickness (R2=0.72 and 0.46, respectively, in simple linear regressions). There was a statistically significant 4.3% increased log VF area variability for every 50% mean log VF area decrease (p<0.001); explaining most of the total variability in log VF area variability (R2=0.44). When controlling for mean log VF area, there was a statistically significant increase in log VF area variability for subjects with greater than minimal depressive symptoms (p=0.015), with increased mean irritability scores (p=0.02), decreased SF-36 physical functioning subscale scores (p=0.03), or decreased mean score for feeling active, strong and proud (p=0.008) (adjusted R2=0.62). CS variability was low, and not statistically significantly related to mean CS, macular thickness or psychosocial factors. Increased VA and VF variability was predicted largely by increased RP severity. Greater VF variability occurred in subjects with reduced VF who reported less physical activity or increased negative psychosocial states. These associations should be considered during clinical exams and trials for RP.