The role of the spectral domain ocular coherence tomography in detection of age-related macular degeneration [Uloga Spectral domain okularne koherentne tomografije u dijagnostici senilne degeneracije makule]

Mrak, Bernard and Čaljkušić-Mance, Tea and Mrak, Bernarda and Cerovski, Branimir and Trobonjača, Zlatko (2011) The role of the spectral domain ocular coherence tomography in detection of age-related macular degeneration [Uloga Spectral domain okularne koherentne tomografije u dijagnostici senilne degeneracije makule]. Collegium antropologicum, 35 (S. 2). pp. 157-60. ISSN 0350-6134

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Abstract

Age-related macular degeneration (ARMD) is one of the most common causes of the vision loss and blindness in developed countries. Among other harmful effects, exposure to the UV radiation is the most prominent factor for the development of the disorder. Using the method of SD OCT (Spectral Domain Ocular Coherence Tomography) we performed measurement of the neurosensory retinal thickness of 19 eyes of low vision patients from the population of Primorsko-Goranska County of Republic of Croatia, with dry form of the terminal macular degeneration. These results we compared with control measurements performed on 28 eyes of healthy, normal vision subjects from same County. We determined following parameters: central foveal thickness (CFT), macular volume (MV) and mean foveal thickness (MFT) in the both groups. Results showed statistically significant reduction of CFT in the group of normal vision female patients when compared to males, while any significant difference of CFT between total groups of normal vision individuals and low vision patients was not detected. Furthermore, we noticed statistically significant (p < 0.000001) decrease of the MV in the group of the low vision patients in comparison to healthy subjects and statistically significant (p < 0.000001) reduction of the MFT of the low vision patients when compared to normal vision individuals. In our study we detected the absence of any significant difference of the CFT between healthy and low vision population, what looks like controversial finding, because neurosensory retina in the ARMD is thin and atrophic, but on the other side it is known that fixation point in low vision patients is translocated from the damaged fovea to extrafoveal region, usually above the fovea, where neurosensory retina is of the normal thickness, but with the less sensitivity. Furthermore, our results suggest possible connection of higher incidence of ARMD with lower CFT in females. Owing to the thicker neurosensory retina in males and better protection, damaging effect of the UV irradiation, which is the proven factor of ARMD development, is smaller. From the evolutionary point of view it is possible that males in all vertebrates have more resistant macula because during the evolutionary process they have spent much more time outside in the sunlight than females.

Abstract in Croatian

Senilna degeneracija makule (SDM) je jedan od najčešćih uzroka gubitka vida i sljepoće u razvijenim zemljama, pri čemu je izloženost UV radijaciji značajan faktor rizika nastanka bolesti. Uz pomoć SD OCT (Spectral Domain okularna koherentna tomografija) aparata izvršeno je antropometrijsko mjerenje i usporedba debljine neurosenzorne retine u zdrave, normovidne populacije Primorsko Goranske Županije (PGŽ), te slabovidne populacije PGŽ i to sa suhom terminalnom formom SDM. Izmjerene su vrijednosti: centralne fiksacijske debljine (CFT), makularnog volumena (MV), te srednja fiksacijaka debljina (MFT). Statistički neznačajna razlika CFT u zdrave i slabovidne skupine je podatak koji je paradoksalan, obzirom da znamo kako je u suhoj degeneraciji makule neurosenzorna retina atrofična, stanjena. Ove rezultate objašnjavamo već poznatim fenomenom dislokacije oštećene fiksacijske točke extrafoveolarno, i to iznad foveole, u područje s debljom neurosenzornom retinom, no s manjom perceptivnom osjetljivošću. Statistički značajno manja CFT u zdravih žena (206,45 mikr) u odnosu na zdrave muškarce (223,63) navodi na originalnu, antropološku hipotezu, primjenjivu i na sve kralježnjake da je moguća povezanost veće učestalosti SDM u žena s manjom CFT u žena. Muška bi populacija prema ovoj hipotezi, zahvaljujući debljoj neurosenzornoj retini mogla imati jači biološki štit od svjetlosnih, osobito UV zračenja, koja su dokazano provocirajući faktor razvoja SDM. Evolucijsko gledano ova je teorija o povezanosti debljine makule i spolno nesrazmjerne učestalosti SDM poveziva s dnevnim životnim ritmom – uglavnom van doma, na suncu u muškaraca, te uglavnom unutar doma, zaštićeno od sunca u žena.

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