目的:使用自适应光学扫描激光检眼镜(AO-SLO)和显微视野(MP)评估激光诱发视网膜病变(LIR)的视锥光感受器形态和相关的视网膜敏感性。
方法:队列研究。
方法:本研究包括13名LIR患者(15只眼)和38名年龄匹配的健康志愿者(38只眼)。参与者接受了包括AO-SLO在内的全面评估,MP,和谱域OCT。病变形态,锥密度,评估了AO-SLO的分散性和规律性,并与视觉功能相关。
结果:在AO-SLO图像中,LIR病变主要表现为低反射区,提示中央凹潜在的视锥丢失,伴随着这些病变中存在大量的高反射物质。受累眼睛的平均病变大小为97,128±107,478μm²,范围从6,705到673,348μm²。与健康对侧眼和对照组相比,LIR显示出显著降低的锥密度,增加圆锥色散,在3°偏心率下,所有四个象限的圆锥规律性显着降低(所有P值<0.05)。AO-SLO的病变形态与OCT中观察到的EZ缺陷相关,显示大小呈正相关(r=0.84,P<0.001),但与视网膜敏感性无关(P=0.09)。同样,3°偏心率下的视锥密度与视网膜敏感性无相关性(P=0.13)。
结论:该研究为LIR对视锥细胞的形态学和功能影响提供了重要的见解,揭示了视锥细胞的显著形态变化,这些变化与功能结果并不一致。这项研究强调需要继续探索LIR中视网膜结构和功能之间的关系,以及提高公众意识和预防战略以减轻LIR风险的重要性。
OBJECTIVE: To assess the cone photoreceptors\' morphology and associated retinal sensitivity in laser-induced retinopathy (LIR) using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and microperimetry (MP).
METHODS: Cohort study.
METHODS: This study included 13 patients (15 eyes) with LIR and 38 age-matched healthy volunteers (38 eyes). Participants underwent comprehensive evaluations including AO-SLO, MP, and spectral-domain OCT. Lesion morphology, cone density, dispersion, and regularity in AO-SLO were assessed and correlated with visual function.
RESULTS: In AO-SLO images, LIR lesions were predominantly characterized by hyporeflective regions, suggesting potential cone loss at the fovea, accompanied by the presence of sizable clumps of hyperreflective material within these lesions. The average size of lesions in affected eyes was 97,128±107,478 µm², ranging from 6705 to 673,348 µm². Compared with the healthy contralateral eye and control group, LIR demonstrated significantly reduced cone density, increased cone dispersion, and notably decreased cone regularity in all 4 quadrants at 3° eccentricity (all P values < .05). Lesion morphology in AO-SLO correlated with ellipsoid zone defects observed in OCT, showing a positive correlation in size (r = 0.84, P < .001) but not with retinal sensitivities (P = .09). Similarly, cone density at 3° eccentricity did not correlate with retinal sensitivities (P = .13).
CONCLUSIONS: The study provides crucial insights into the morphologic and functional impacts of LIR on cone photoreceptors, revealing significant morphologic changes in cones that do not consistently align with functional outcomes. This research highlights the need for continued exploration into the relationship between retinal structure and function in LIR, and the importance of heightened public awareness and preventive strategies to mitigate the risk of LIR.