在 dysthyroid 光神经病变的轨道减压后,对比度敏感度和生活质量
Marie Callet1,2, Edgard Farah3, Natacha Stolowy4
1Department of Oculoplastics and Ophthalmology, Rothschild Foundation Hospital, Paris, France. marie_callet@hotmail.com.
概括
患有甲状腺眼病 (TED) 和压缩性视神经病变 (CON) 的患者即使在视力敏度恢复后,也会表现出持续的对比敏感性缺陷. 这种降低的对比度敏感性会影响与视觉相关的生活质量.
科学领域:
- 眼科医生 眼科 眼科
- 神经眼科 神经眼科
- 内分泌学 在内分泌学.
背景情况:
- 甲状腺眼病 (TED) 可以导致压缩性视神经病变 (CON).
- 三壁轨道减压手术用于治疗TED患者的CON.
- 视敏度 (BCVA) 和视野的完全恢复通常在手术后实现.
研究的目的:
- 在成功的轨道减压后,评估TED患者的对比敏感功能 (CSF).
- 评估剩余的CSF赤字对视觉相关生活质量 (QOL) 的影响.
主要方法:
- 一项前性匹配病例对照研究比较了22个TED眼睛 (18个CON,4个非CON) 和22个健康眼睛.
- 所有TED患者在手术后都达到10/10BCVA,视野正常,没有OCT异常.
- 使用CSV-1000E测量对比度灵敏度,用GO-QOL视觉功能的子级别评估QOL.
主要成果:
- 与对照人群相比,TED-CON眼睛的CS显著降低 (p<0.01),特别是在低空间频率下.
- 没有前科的TED眼睛也显示出不正常的CS,表明亚临床视神经功能障碍.
- CS赤字与较低的GO-QOL分数 (ρ=-1.00,p<0.001) 有很强的相关性.
结论:
- 在TED患者中持续存在的对比敏感性缺陷,先前的CON表明不可逆转或亚临床的视神经损伤.
- 对比敏感性测试是TED视神经应激的敏感标记,影响患者的QOL.
- 微妙的功能障碍甚至可能存在于没有CON的TED眼睛中.
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