Influence of laser photocoagulation for clinically significant diabetic macular oedema (DMO) on short-wavelength and conventional automated perimetry
Influence of laser photocoagulation for clinically significant diabetic macular oedema (DMO) on short-wavelength and conventional automated perimetry
复制标题
DOI：
10.1007/s001250051066
复制
发表时间：
1998-11-01
期刊：
影响因子：
8.2
通讯作者：
McLeod, D
中科院分区：
文献类型：
--
作者：
Hudson, C;Flanagan, JG;McLeod, D
本研究的目的是通过常规和短波长自动静态阈值视野计评估，确定激光光凝治疗临床显著的糖尿病黄斑水肿（DMO）对黄斑视功能的影响。样本包括24例需要激光光凝治疗临床显著DMO的患者（平均年龄59.75岁，范围45-75岁）。选择每例患者的一只眼睛进行研究。患者在治疗前和治疗后1周内以及治疗后1、2、4和12周分别使用Humphrey视野分析仪的程序10-2进行常规和短波长视野检查。分析了常规视野检查的逐点模式偏差图，并推导了短波长视野检查的逐点水平和垂直半视野不对称性分析（从而消除了前感受器吸收的影响）。灵敏度损失的程度通过统计概率水平p小于0.05的刺激位置的数量来确定。在研究过程中，组平均对数最小分辨角（logMAR）视力基本不变。常规视野检查显示异常连续刺激位置的组平均数量从治疗前即刻的2.4（SD 4.3，范围0-14）增加至治疗1周内的12.4（SD 7.8，范围0-30）;治疗后3个月，异常连续刺激位置的组平均数量为8.1（SD 6.5，范围0-20）。短波长视野检查发现了类似但不太明显的变化。治疗后局部敏感性丧失的空间位置与视网膜光凝区域相对应。尽管已证明在稳定视力方面有好处，但激光光凝治疗临床上明显的DMO总是会导致视网膜中央凹10度偏心率内的周边敏感度局部丧失。必须重新检查激光治疗临床显著DMO的价值的证据。
The aim of the study was to determine the effect of laser photocoagulation for clinically significant diabetic macular oedema (DMO) on macular visual function as assessed by conventional and short-wavelength automated static threshold perimetry. The sample comprised 24 patients who required laser photocoagulation for clinically significant DMO (mean age 59.75 years, range 45-75 years). One eye of each patient was selected for the study. Patients underwent conventional and short-wavelength perimetry using programme 10-2 of the Humphrey Field Analyser on two separate occasions prior to treatment and subsequently within 1 week of, and at 1, 2, 4 and 12 weeks after, treatment. The pointwise pattern deviation plot was analysed for conventional perimetry and a pointwise horizontal and vertical hemifield asymmetry analysis was derived for short-wavelength perimetry (thereby negating the influence of pre-receptoral absorption). The extent of sensitivity loss was determined by counting the number of stimulus locations with statistical probability levels of p less than 0.05. Group mean log minimum angle of resolution (logMAR) visual acuity was largely unchanged over the course of the study. Conventional perimetry showed an increase in the group mean number of abnormal contiguous stimulus locations from 2.4 (SD 4.3, range 0-14) immediately prior to treatment, to 12.4 (SD 7.8, range 0-30) within 1 week of treatment; at 3 months post-treatment, the group mean number of abnormal contiguous stimulus locations was 8.1 (SD 6.5, range 0-20). A similar but less pronounced change was found for short-wavelength perimetry. The spatial position of the posttreatment localised sensitivity loss corresponded with the area of retinal photocoagulation. Despite proven benefit in the stabilisation of visual acuity, laser photocoagulation for clinically significant DMO invariably results in a localised loss of perimetric sensitivity within 10 degrees eccentricity of the fovea. Evidence for the value of laser therapy for clinically significant DMO must be re-examined.