暗适应动力学区分年龄相关性黄斑变性与中央浆液性脉络膜视网膜病变

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-05-26 DOI:10.1016/j.xops.2025.100835

Ashwin P. Verghese BE , Claudia C. Lasalle BA , David J. Ramsey MD, PhD

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引用次数: 0

摘要

目的评价暗适应（DA）棒截距时间（RIT）在年龄相关性黄斑变性（AMD）和中心性浆液性脉络膜视网膜病变（CSCR）诊断中的应用价值。设计回顾性连续病例系列。参与者：临床诊断为AMD或CSCR的连续患者，年龄≥50岁。方法本研究纳入了完成了≥1只眼视网膜中央窝上5°测量的DA研究的患者。所有患者都接受了全面的视网膜检查，包括黄斑的OCT评估。主要结果测量：根据患者的RIT进行分类，RIT = 6.50分钟视为延迟。结果本研究纳入67例AMD患者和25例CSCR患者。AMD患者年龄偏大（73.8±8.9岁vs 65.0±7.2岁），P <；0.001)，并且与CSCR组相比，更有可能是女性（53.7%比28.0%,P = 0.049）。此外，AMD患者在良好视力（最小分辨率角度的对数为0.14±0.13比0.08±0.13,P = 0.057）和较差视力（最小分辨率角度的对数为0.48±0.47比0.26±0.25,P = 0.028）两种情况下均倾向于表现出较差的视力。与CSCR患者相比，AMD患者的棒截距时间较慢，两者均为快速适应(12.44±6.96分钟vs 4.01±1.28分钟，P <；0.001)和较慢适应(13.06±6.67分钟vs 4.95±1.78分钟，P <；0.001)的眼睛。在快速适应眼中使用延迟RIT对AMD患者与CSCR进行分类显示出优异的性能，灵敏度为79.1%(95%置信区间[CI]: 67.4%-88.1%)，完美特异性为100.0% (95% CI: 86.3%-100.0%)，准确度为97.4% （95% CI: 91.7%-99.6%）。在调整了年龄、性别和视力后，快速适应眼的RIT仍然是AMD与CSCR的独立预测因子。结论长时间的暗适应，以较长的RIT为标志，能够区分AMD和CSCR，这两种情况具有相似的眼底特征。未来的研究需要评估这种无创技术对AMD筛查的有效性。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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Dark Adaptometry Kinetics Differentiates Age-Related Macular Degeneration from Central Serous Chorioretinopathy

Purpose

To assess the diagnostic utility of dark adaptometry (DA) rod intercept time (RIT) to differentiate age-related macular degeneration (AMD) from central serous chorioretinopathy (CSCR).

Design

Retrospective consecutive case series.

Participants

Consecutive patients with a clinical diagnosis of AMD or CSCR who were ≥50 years of age.

Methods

The study included patients who had completed a DA study in ≥1 eye measured at 5° superior to the fovea on the retina. All patients underwent a comprehensive retina examination, including OCT assessment of the macula.

Main Outcome Measures

Patients were classified based on their RIT, with an RIT >6.50 minutes considered a delay.

Results

The study included 67 patients with AMD and 25 with CSCR. Patients with AMD tended to be older (73.8 ± 8.9 years vs. 65.0 ± 7.2 years, P < 0.001) and were more likely female (53.7% vs. 28.0%, P = 0.049) compared with their CSCR counterparts. Additionally, patients with AMD tended to exhibit poorer vision in both their better-seeing (logarithm of the minimum angle of resolution 0.14 ± 0.13 vs. 0.08 ± 0.13, P = 0.057) and worse-seeing (logarithm of the minimum angle of resolution 0.48 ± 0.47 vs. 0.26 ± 0.25, P = 0.028) eyes. Rod intercept times were slower in patients with AMD compared with CSCR, both in the faster-adapting (12.44 ± 6.96 minutes vs. 4.01 ± 1.28 minutes, P < 0.001) and slower-adapting (13.06 ± 6.67 minutes vs. 4.95 ± 1.78 minutes, P < 0.001) eyes. Using a delayed RIT in the faster-adapting eye to classify patients with AMD versus CSCR showed excellent performance with a sensitivity of 79.1% (95% confidence interval [CI]: 67.4%–88.1%) and perfect specificity of 100.0% (95% CI: 86.3%–100.0%), yielding an accuracy of 97.4% (95% CI: 91.7%–99.6%). After adjusting for age, sex, and visual acuity, RIT in the faster-adapting eye remained an independent predictor of AMD versus CSCR.

Conclusions

Prolonged dark adaptation, indicated by a longer RIT, is capable of distinguishing individuals with AMD from CSCR, 2 conditions that share similar fundus features. Future investigations are warranted to assess the effectiveness of this noninvasive technique for AMD screening.