Macular cone abnormalities in retinitis pigmentosa with preserved central vision using adaptive optics scanning laser ophthalmoscopy.
Macular cone abnormalities in retinitis pigmentosa with preserved central vision using adaptive optics scanning laser ophthalmoscopy.
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DOI：
10.1371/journal.pone.0079447
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Yoshimura N
中科院分区：
文献类型：
--
作者：
Makiyama Y;Ooto S;Hangai M;Takayama K;Uji A;Oishi A;Ogino K;Nakagawa S;Yoshimura N
应用自适应光学扫描激光检眼镜（AO-SLO）评估保留中心视觉的视网膜色素变性（RP）患者黄斑光感受器异常。14例RP（最佳矫正视力20/20或更高）患者的14只眼睛和12名志愿者的12只眼睛接受了全面的眼科检查、眼底自身荧光、光谱域光学相干断层扫描（SD-OCT）和原型AO-SLO系统成像。利用AO-SLO图像对锥体密度和锥体马赛克的空间组织进行了评价。在3只RP且中心视力保存的眼中，视锥细胞形成了基本规则的马赛克图案，并有小的斑驳的暗色区域，10只眼的视锥细胞马赛克图案不太规则，可见大面积的暗色区域，且视锥细胞缺失。只有一只眼睛有正常的、规则的锥形镶嵌图案。RP眼距中央凹0.5 mm和1.0 mm处锥体密度显著低于正常眼（P<0.001和0.021）。在距中央凹0.5 mm和1.0 mm处，RP组视锥细胞数量减少，有6个相邻视锥细胞（P = 0.002）。SD-OCT图像上光感受器内段（IS）椭球带的破坏与锥体密度的较大降低有关（P = 0.044）；然而，在SD-OCT上，即使在连续的IS椭球区域，AO-SLO上也能看到暗区。锥体密度降低与SD-OCT上外核层变薄（P = 0.029）和内、外核段厚度变薄（P = 0.011）相关。RP眼的视锥密度降低，视锥嵌合空间排列的规则性被打乱，即使在视力和中央凹灵敏度良好的情况下也是如此。AO-SLO成像是检测RP眼光感受器异常的灵敏定量工具。
To assess macular photoreceptor abnormalities in eyes with retinitis pigmentosa (RP) with preserved central vision using adaptive optics scanning laser ophthalmoscopy (AO-SLO). Fourteen eyes of 14 patients with RP (best-corrected visual acuity 20/20 or better) and 12 eyes of 12 volunteers underwent a full ophthalmologic examination, fundus autofluorescence, spectral-domain optical coherence tomography (SD-OCT), and imaging with a prototype AO-SLO system. Cone density and spatial organization of the cone mosaic were assessed using AO-SLO images. In 3 eyes with RP and preserved central vision, cones formed a mostly regular mosaic pattern with small patchy dark areas, and in 10 eyes, the cone mosaic patterns were less regular, and large dark regions with missing cones were apparent. Only one eye with RP demonstrated a normal, regular cone mosaic pattern. In eyes with RP, cone density was significantly lower at 0.5 mm and 1.0 mm from the center of the fovea compared to normal eyes (P<0.001 and 0.021, respectively). At 0.5 mm and 1.0 mm from the center of the fovea, a decreased number of cones had 6 neighbors in eyes with RP (P = 0.002 for both). Greater decrease in cone density was related to disruption of the photoreceptor inner segment (IS) ellipsoid band on SD-OCT images (P = 0.044); however, dark regions were seen on AO-SLO even in areas of continuous IS ellipsoid on SD-OCT. Decreased cone density correlated thinner outer nuclear layer (P = 0.029) and thinner inner segment and outer segment thickness (P = 0.011) on SD-OCT. Cone density is decreased and the regularity of the cone mosaic spatial arrangement is disrupted in eyes with RP, even when visual acuity and foveal sensitivity are good. AO-SLO imaging is a sensitive quantitative tool for detecting photoreceptor abnormalities in eyes with RP.
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作者：
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