论文部分内容阅读
目的检测正常人及特发性黄斑前膜患者的对比敏感度(CSF),评价CSF与视力、黄斑中心凹厚度改变的相互关系。设计前瞻性病例对照研究。研究对象正常人80例(80眼),其中老年组(60~80岁)26例、中年组(40~59岁)30例和青年组(<40岁)24例。特发性黄斑前膜患者31例(43眼),其中水肿性前膜31眼,增生性前膜12眼。方法应用对比敏感度检测卡(FACT)测定对比敏感度值,相干光断层扫描仪(OCT)测量黄斑中心凹厚度。主要指标视力、对比敏感度、黄斑中心凹厚度。结果正常人CSF曲线为一钟型曲线,中频区3~6周/度处敏感度最高,40岁以上者峰值位于3周/度,<40岁者峰值位于6周/度。中年组较青年组中频敏感度下降(P<0.05),老年组较中年组在中、高频率对比值均降低(P<0.05)。特发性黄斑前膜与正常老年组CSF曲线比较,视力≥1.0组、0.9~0.5组、≤0.4组各空间频率敏感度均下降;视力≥1.0时CSF已出现高空间频率敏感度下降(P<0.05);视力在0.9~0.5时出现全频率敏感度降低(P<0.01);视力降到0.4以下时CSF进一步降低,与对照组比较各空间频率均有非常显著性差异(P<0.01)。水肿性前膜组和增生性前膜组各空间频率敏感度也均有下降。水肿性前膜组只有高频区对比敏感度的改变且具有统计学意义(P<0.01);而增生性前膜组全空间频率对比度均显著性下降(P<0.01)。特发性黄斑前膜患者的中心凹厚度与视力、CSF改变呈显著负相关(P<0.05)。结论CSF可灵敏、全面地反映出特发性黄斑前膜患者早期视功能状态,可用于观察其病情进展情况,成为确定进一步治疗方案、观察疗效的重要视功能检查方法。
Objective To detect the contrast sensitivity (CSF) between normal subjects and patients with idiopathic macular degeneration and to evaluate the relationship between CSF and visual acuity and foveal thickness changes. Design prospective case-control study. Totally 80 subjects (80 eyes) were normal subjects, including 26 elderly patients (60-80 years old), 30 middle age patients (40-59 years old) and 24 youths (<40 years old). There were 31 patients with idiopathic macular degeneration (43 eyes), including 31 edematous anterior membrane and 12 proliferative anterior membrane. Methods Contrast sensitivity test (FACT) was used to measure contrast sensitivity and coma thickness (CCT) was measured by coherence tomography (OCT). The main indicators of visual acuity, contrast sensitivity, macular foveal thickness. Results The normal CSF curve was a bell curve with the highest sensitivity at 3-6 weeks / degree in the middle frequency region, the peak at 3 weeks / degree at 40 years of age, and the peak at <40 years at 6 weeks / degree. The middle frequency group had lower frequency sensitivity than the young group (P <0.05), and the middle and high frequency comparison rate of the aged group was lower than that of the middle age group (P <0.05). Compared with the normal elderly group, the CSF curve of idiopathic macular dementia showed that the spatial frequency sensitivity of visual acuity≥1.0 group, 0.9-0.5 group and≤0.4 group decreased, while the spatial frequency sensitivity of high frequency spatial frequency decreased (P <0.01); visual acuity decreased to below 0.4 when the CSF decreased further, compared with the control group, the spatial frequency of each has a very significant difference (P <0.01) . The spatial frequency sensitivity of the edematous anterior membrane group and the proliferative anterior membrane group also decreased. The edematous anterior membrane group only had the contrast sensitivity change in the high frequency area and had statistical significance (P <0.01), while the proliferative anterior membrane group spatial frequency contrast significantly decreased (P <0.01). In patients with idiopathic macular deformity, the thickness of the fovea was negatively correlated with the change of vision and CSF (P <0.05). Conclusions CSF can sensitively and comprehensively reflect the early visual function status of patients with idiopathic macular degeneration and can be used to observe the progression of the disease. It is an important visual function test method for further treatment and observation of curative effect.