Progressive Loss of Retinal Ganglion Cell Function Precedes Structural Loss by Several Years in Glaucoma Suspects
Progressive Loss of Retinal Ganglion Cell Function Precedes Structural Loss by Several Years in Glaucoma Suspects
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DOI：
10.1167/iovs.12-11026
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发表时间：
2013-03-01
影响因子：
4.4
通讯作者：
Porciatti, Vittorio
中科院分区：
文献类型：
--
作者：
Banitt, Michael R.;Ventura, Lori M.;Porciatti, Vittorio
目的.我们确定视网膜神经节细胞功能丧失与视网膜神经纤维层（RNFL）厚度之间的时间差。青光眼嫌疑人被跟踪至少四年。患者每隔6个月进行图形视网膜电图（PERG）、RNFL的光学相干断层扫描（OCT）和标准自动视野检查。在所有测试模式的变化之间进行了比较。为了在归一化尺度上比较PERG和OCT测量，我们计算了PERG振幅和RNFL厚度的动态范围。功能和结构之间的时间滞后被定义为PERG振幅和RNFL厚度之间的时间标准损失的差异。对于PERG（P < 0.001）和RNFL（P = 0.030），对应于最低基线PERG振幅分层（90%）的斜率之间存在统计学显著差异。事后比较表明，在受影响最严重的PERG（70%）层中，眼睛的RNFL厚度之间存在高度显著差异。据估计，PERG振幅需要1.9至2.5年才能损失其初始振幅的10%，而RNFL厚度需要9.9至10.4年才能损失其初始厚度的10%。因此，PERG振幅和RNFL厚度损失10%的初始值之间的时间滞后是8年的顺序。在疑似青光眼的患者中，PERG信号预期OCT信号的等效损失为几年。（Invest Ophthalmol维斯科学。2013;54：2346-2352）DOI：10.1167/iovs.12-11026
PURPOSE. We determined the time lag between loss of retinal ganglion cell function and retinal nerve fiber layer (RNFL) thickness.METHODS. Glaucoma suspects were followed for at least four years. Patients underwent pattern electroretinography (PERG), optical coherence tomography (OCT) of the RNFL, and standard automated perimetry testing at 6-month intervals. Comparisons were made between changes in all testing modalities. To compare PERG and OCT measurements on a normalized scale, we calculated the dynamic range of PERG amplitude and RNFL thickness. The time lag between function and structure was defined as the difference in time-to-criterion loss between PERG amplitude and RNFL thickness.RESULTS. For PERG (P < 0.001) and RNFL (P = 0.030), there was a statistically significant difference between the slopes corresponding to the lowest baseline PERG amplitude stratum (90%). Post hoc comparisons demonstrated highly significant differences between RNFL thicknesses of eyes in the stratum with most severely affected PERG (70%). Estimates suggested that the PERG amplitude takes 1.9 to 2.5 years to lose 10% of its initial amplitude, whereas the RNFL thickness takes 9.9 to 10.4 years to lose 10% of its initial thickness. Thus, the time lag between PERG amplitude and RNFL thickness to lose 10% of their initial values is on the order of 8 years.CONCLUSIONS. In patients who are glaucoma suspects, PERG signal anticipates an equivalent loss of OCT signal by several years. (Invest Ophthalmol Vis Sci. 2013;54:2346-2352) DOI: 10.1167/iovs.12-11026