目的：利用双通道视觉质量分析系统对黄斑水肿(ME)患者的光学质量和眼内散射进行评估，探讨视网膜病变对光学质量的影响。

方法：前瞻性病例对照研究。选取2019-08/2020-01在我院眼科检查确诊的ME患者49例58眼为ME组，对照组选择性别年龄范围匹配的眼健康志愿者30例30眼纳入研究。记录两组患者的临床资料，在相同的测试条件下，由同一测试者采用OQAS^TMⅡ受试者对进行视觉质量的检查，包括调制传递函数截止空间频率(MTF cutoff)、斯特列尔比值(SR)、对比度为100%、20%、9%时的OV值(OV100%、OV20%、OV9%)以及客观散射指数(OSI)等。分析比较两组之间的差异性以及ME患者黄斑中心凹厚度及容积与视觉质量的相关性。

结果：ME组患者平均最佳矫正视力显著低于对照组，黄斑中心凹厚度及容积显著高于对照组(P<0.001)。与对照组相比，ME组患者OSI显著增高，MTF cutoff、SR、OV100%、OV20%、OV9%显著降低(P<0.001)。ME组患者黄斑中心凹厚度与OSI呈正相关(r=0.566， P<0.001)； 与MTF cutoff(r=-0.336，P=0.010)、OV100%(r=-0.326， P=0.013)、OV20%(r=-0.349， P=0.007)和OV9%(r=-0.321， P=0.014)呈负相关，与SR无相关性。ME组患者黄斑中心凹容积与OSI呈正相关(r=0.574， P<0.001)； 与MTF cutoff(r=-0.367， P=0.005)、SR(r=-0.265， P=0.045)、OV100%(r=-0.351， P=0.007)、OV20%(r=-0.385， P=0.003)和OV9%(r=-0.375， P=0.004)呈负相关。

结论：ME患者的视觉质量低于正常人群，黄斑部视网膜形态和厚度的变化可影响光学质量和眼内散射。OQAS^TMⅡ所测得的光学质量参数可能为黄斑功能的评估提供新的临床参考数据。

METHODS: This was a prospective case-control study. Fifty-eight eyes of 49 macular edema patients who were confirmed by ophthalmic examination in our hospital from August 2019 to January 2020 were selected as the ME group, and 30 eyes of 30 healthy volunteers who were matched with gender and age range for the study were selected for the normal control group. The clinical data of the two groups of patients were recorded. Under the same test conditions, the same operator used OQAS^TMⅡ to check the visual quality of the study object, including the cutoff of the modulation transfer function(MTF cutoff), strehl ratio(SR), OQAS^TMⅡ values(100%, 20%, 9%)and contrast levels(OV100%, OV20%, OV9%). The difference of data between the two groups were analyzed, and the correlation between the visual quality and the thickness and volume of the macular fovea in the ME group were analyzed.

RESULTS: The average best corrected visual acuity in the macular edema group was significantly lower than the control group, and the thickness and volume of macular fovea were significantly higher than the control group(P<0.001). Compared with the control group, the OSI of the macular edema group was significantly higher, and MTF cutoff, SR value, OV(100%, 20%, 9%)significantly decreased(P<0.001). In the macular disease group, the thickness of macular fovea was positively correlated with OSI(r=0.566, P<0.001), while MTF cutoff(r=-0.336, P=0.010), OV100%(r=-0.326, P=0.013), OV20%(r=-0.349, P=0.007)and OV9%(r=-0.321, P=0.014)were negative correlation, but it had no correlation with SR. In the macular edema group, the volume of macular fovea was positively correlated with OSI(r=0.574, P<0.001). It was negatively correlated with MTF cutoff(r=-0.367, P=0.005), SR(r=-0.265, P=0.045), OV100%(r=-0.351, P=0.007), OV20%(r=-0.385, P=0.003)and OV9%(r=-0.375, P=0.004).

CONCLUSION: The optical quality of patients with macular edema is lower than the normal population, and the changes in macular retina morphology and thickness could affect the optical quality and intraocular scattering. The optical quality parameters measured by OQAS^TMⅡ may provide new clinical reference for macular function evaluation.