Abnormal fundus autofluorescence in relation to retinal function in patients with retinitis pigmentosa
Abnormal fundus autofluorescence in relation to retinal function in patients with retinitis pigmentosa
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DOI：
10.1007/s00417-005-1186-x
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发表时间：
2005-10-01
影响因子：
2.7
通讯作者：
Hawlina, M
中科院分区：
文献类型：
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作者：
Popovic, P;Jarc-Vidmar, M;Hawlina, M
背景：一些色素性视网膜炎患者的眼底自身荧光（AF）表现为中心周围有一个增加的AF的近中央凹环，周围出现低荧光变化。本研究的目的是评估AF模式与视网膜电图和视野测量的视网膜功能的关系。方法：选取32例RP患者进行研究。采用扫描式激光检眼镜对黄斑区进行AF成像。根据患者眼底AF类型分为两组。1组患者均有不同大小的心房颤动增大环，但血管拱廊内无萎缩区。组2选择心房颤动增加的环形和中央凹不同偏心的圆形萎缩性改变的患者。采用动态、自动和显微视野法检测视野；比较高荧光环半径、低荧光区距中央凹的最小距离、视野、内三个环的PERG P50、N95和mfERG P1振幅。结果：第一组AF增大环半径与自动视野（r=0.82）和动态视野（r=0.80）均呈线性关系。AF环半径与PERG P50 （r=0.72）和N95 （r=0.74）高度相关。在所有患者中，mfERG反应在所有视网膜位置都降低，在周围更明显。AF增加环与mfERG 2环P1幅值有较好的相关性（r=0.62）。2组患者的perg和mferg明显减少或不可记录。低荧光改变的偏心率与任何类型的视野检查无关。结论：我们的研究结果表明，在视网膜色素变性的各个阶段，萎缩性病变在血管拱廊内扩散之前，眼底自身荧光的模式与视力检查和视网膜电图等功能检查有很好的相关性。AF增加的环形似乎代表了功能视网膜和功能不全视网膜之间的边界。这表明自体荧光作为一种快速、无创的成像工具，也可能与视网膜功能有关。
Background: Fundus autofluorescence (AF) in some patients with retinitis pigmentosa is characterized by a parafoveal ring of increased AF which surrounds the centre as hypofluorescent changes appear at the periphery. The aim of this study was to evaluate the AF patterns in relation to retinal function measured by electroretinography and visual fields. Methods: Thirty-two patients with RP were included in the study. AF imaging of the macular area was performed with the scanning laser ophthalmoscope. Patients were divided in two groups according to their fundus AF patterns. All patients from group 1 had a ring of increased AF of different size but no atrophic areas inside vascular arcades. Patients with a ring of increased AF and round atrophic changes at different eccentricities from their fovea were selected in group 2. Visual fields were tested with kinetic, automated perimetry and microperimetry; the radius of the hyperfluorescent ring and the smallest distance of hypofluorescent areas from the fovea were compared to visual fields, PERG P50 and N95 and mfERG P1 amplitudes of the inner three rings. Results: A linear relationship was found in group 1 between the radius of the ring of increased AF and both the automated (r=0.82) and kinetic perimetry (r=0.80). The radius of the AF ring correlated highly with the PERG P50 (r=0.72) and N95 (r=0.74) amplitudes. In all patients, mfERG responses were reduced at all retinal locations, more pronounced at periphery. There was a good correlation between the ring of increased AF and the P1 amplitude of ring 2 of mfERG (r=0.62). Patients from group 2 had significantly reduced or non-recordable PERGs and mfERGs. The eccentricities of hypofluorescent changes did not correlate with any type of perimetry. Conclusions: Our results show that in stages of retinitis pigmentosa, before atrophic lesions spread inside the vascular arcades, the pattern of fundus autofluorescence correlates well with functional tests such as perimetry and electroretinography. The ring of increased AF appears to represent the border between functional and dysfunctional retina. This shows that autofluorescence, as a quick and non-invasive imaging tool, may be related to retinal function as well.