Longitudinal natural history study of visual acuity in choroideremia
10.3760/cma.j.cn511434-20231012-00416
- VernacularTitle:无脉络膜症患者的纵向视力自然病程
- Author:
Xiaoxu HAN
1
;
Dingding ZHANG
;
Hui LI
;
Xuan ZOU
;
Ruifang SUI
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院眼科，北京 100730
- Keywords:
Choroideremia;
Visual acuity;
Longitudinal natural history;
Binocular correlation
- From:
Chinese Journal of Ocular Fundus Diseases
2024;40(5):347-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe and analyze the rate of visual acuity progression and binocular symmetry in patients with choroideremia (CHM).Methods:A single-center retrospective longitudinal cohort study. From April 2009 to August 2022, 38 eyes of 19 patients diagnosed with CHM through clinical and genetic testing at the Department of Ophthalmology, Peking Union Medical College Hospital, were included in this study. All patients underwent at least 2 follow-up visits with a minimum interval of 1 year between visits, and binocular best-corrected visual acuity (BCVA) results were recorded at each follow-up visit. Decimal visual acuity was converted into logarithm of the minimum angle of resolution (logMAR) for analysis. The patient group consisted of 19 males from 16 unrelated families. The age at initial visit was (39.52±13.24) years, with a (2.63±1.61) follow-up visits over a duration of (4.95±2.68) years. A total of 50 binocular BCVA data were included. Annual progression rate of visual acuity was calculated based on longitudinal and cross-sectional data. Spearman correlation coefficient and Bland-Altman method were used to evaluate the binocular symmetry.Results:The rate of visual acuity progression was (0.095±0.148) logMAR units/year based on longitudinal data and (0.018±0.009) logMAR units/year based on cross-sectional data. The binocular symmetry for BCVA of the baseline values was strong; however, the binocular symmetry of progression rates for BCVA was moderate. Spearman correlation analysis showed that binocular symmetry in baseline BCVA was high ( r=0.881, P<0.001). The symmetry of binocular vision progression rates based on longitudinal data was moderately symmetric ( r=0.528, P=0.020). Bland-Altman analysis showed that 94.7% of binocular baseline BCVA differences were within 95% confidence interval ( CI) of 95% limit difference (LOA), indicating good symmetry of binocular baseline BCVA. The number of binocular BCVA progression rate differences within 95% CI of 95%LOA was 89.5%, suggesting moderate symmetry in binocular BCVA progression rate. The results of Spearman correlation coefficient and Bland-Altman analysis of binocular symmetry were basically consistent. Conclusions:The rate of visual acuity progression of patients with CHM based on longitudinal and cross-sectional data is (0.095±0.148) and (0.018±0.009) logMAR units/year, respectively. Cross-sectional data from patients of different ages should not be used to infer the progression rate of the natural history. Binocular eyes with highly symmetrical baseline visual acuity may differ in the rate of visual acuity progression.
