| Objective:To observe the changes of retinal structure and function of the macular area of patients with advanced RP,including changes in visual acuity,retinal thickness,multifocal electroretinograms and microperimetry.Methods:The study included two parts.The first part: To compare advantages and disadvantages of Mf-ERG and MP in the evaluation of macular function,and observe the changes of macular function in advanced RP.The amplitude and latency of P1 wave in the center ring 1 measured by Mf-ERG,and the macular sensitivity measured by MP were used as evaluation indexes of macular function,and the coutinuity of ellipsoid zone was used as grouping criterion,when compare the correlation between these two methods and BCVA.The second part: Further analysis of the reliability and effectiveness of MP in monitoring macular function of advanced RP.The thickness of inner and outer layer of the retina in macular area were measured by SD-OCT.The relationship between the thickness and the retinal sensitivity of the corresponding site was analysed to evaluate the correlation between Structure and function.Results: The first part:A total of 49 patients with 98 eyes were included.BCVA was(53.10 ± 22.00)letters,amplitude density of P1 wave in ring 1 measured by Mf-ERG was(7.39 ± 6.14)?V / deg2;MS was(15.49 ± 9.24)dB.Among them,there was a strong correlation between MS and BCVA in the macular area(r=0.783,P<0.001),and certain correlation between the amplitude of P1 wave in the macular area and BCVA(r=0.220,P < 0.05).There was a correlation between the MS and the amplitude of the P1 wave in the macular area(r=0.256,P<0.05).The study showed that MS is more representative of the visual function of advanced RP than the amplitude density of P1 wave in MF-ERG.The second part:A total of 23 patients with 46 eyes were included,the best corrected visual acuity(BCVA)was(48.20±22.22)letters,the MS was(13.30±9.53)dB,and the foveal macular thickness(FMT)was(228.72 ± 54.57)?m.There was a strong correlation between the MS and BCVA(r=0.682,P<0.05),and there was a certain correlation between FMT and BCVA(r=0.409,P < 0.05).There was a weak correlation between MS and FMT(r=0.311,P<0.05).The nasal 3° and 5° retinal sensitivity(RS)were(10.65±9.82)and(7.02±7.79)dB,and the temporal 3° and 5° RS were(11.43±10.04)and(7.09±8.13)dB.The total retinal thickness(TRT)of the nasal side 3° and 5° regions measured by SD-OCT were(286.43±42.78)and(301.48±39.31)?m;the inner retinal thickness(IRT)were(182.96±30.66)and(211.55±32.64)?m;the outer retinal thickness(ORT)were(103.48±31.56)and(89.99±23.03)?m.The TRT of the temporal side 3° and 5° regions were(255.17±35.85)and(253.43±27.12)?m;the IRT were(155.15±25.21)and(172.85±19.87)?m;the ORT were(100.02±30.83),(80.59 ± 22.91)?m.The RS in nasal,temporal 3° and 5° regions had a certain correlation with the TRT in the corresponding region(3°,5° of the nasal side were r=0.462,P<0.05;r=0.350,P<0.05;3° and 5° of the temporal side were r=0.494,P<0.05,r=0.426,P<0.05).There was no significant correlation with the IRT of the corresponding area(3°,5° of the nasal side were r=0.099,P>0.05,r=0.073,P>0.05,3°,5° of the temporal side were r=0.057,P>0.05,r=0.037,P>0.05).There was significant correlation with the ORT of the corresponding area(3°,5° of the nasal side were r=0.718,P<0.05,r=0.643,P<0.05;3°,5° of the temporal side were r=0.639,P<0.05,r=0.564,P<0.05).Conclusion : Multifocal electroretinograms and microperimetry examination can effectively evaluate the macular function changes in patients with advanced RP,but the microperimetry is more accurate than multifocal electroretinograms.The combination of microperimetry and SD-OCT stratification can effectively evaluate the changes of retinal function and structure in the 10° range of macular area of RP patients.Microperimetry can be used as an sensitive indicator to judge the changes of photoreceptor function in RP lesions. |
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