Monitoring glaucoma progression with visual evoked potentials of the blue-sensitive pathway.
Monitoring glaucoma progression with visual evoked potentials of the blue-sensitive pathway.
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发表时间：
2002-06
影响因子：
4.4
通讯作者：
F. Horn;J. Jonas;W. Budde;A. Jünemann;C. Mardin;M. Korth
中科院分区：
文献类型：
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作者：
F. Horn;J. Jonas;W. Budde;A. Jünemann;C. Mardin;M. Korth
目的探讨蓝黄图形刺激视觉诱发电位在青光眼随访中的价值。方法：这项前瞻性纵向并行研究包括一个异质性队列，包括两组，视野（n = 161）和视野前（n = 118），慢性开角型青光眼患者和113名健康对照者。在视野前青光眼组中，患者表现为视盘的昏迷性异常，最大眼内压高于21 mm Hg，计算机视野检查结果不明显。患者接受了最多三次的VEP测量与蓝黄图案刺激，以及定性和形态学评价的彩色立体视盘照片。测量之间的平均随访时间为24个月。分别分析视野检查前受试者的VEP测量结果，有和没有视神经损伤的进展。青光眼的进展定义为神经视网膜边缘丢失增加。结果：对视野前检查组中有或无青光眼视神经损伤进展的患者的VEP峰值时间进行单独分析，结果显示基线时无显著差异，但在形态学变化明显前2年，疾病进展患者的VEP峰值时间显著延长（P = 0.01）。在观察期间，非进展性疾病患者的VEP在统计学上没有变化。视野检查组和视野前检查组VEP峰时均较对照组明显延长（P < 0.001）。结论：除了检测青光眼性椎间盘萎缩的影像学评估外，蓝黄VEP可能是监测青光眼患者的客观电生理工具，因为峰值时间与视神经损伤的进展显著相关。
PURPOSE To determine the value of visual evoked potentials with blue-on-yellow pattern stimulation in follow-up of glaucoma. METHODS This prospective longitudinal concurrent study included a heterogeneous cohort of two groups, perimetric (n = 161) and preperimetric (n = 118), of patients with chronic open-angle glaucoma and 113 healthy control subjects. In the preperimetric glaucoma group, patients showed glaucomatous abnormalities of the optic disc, maximum intraocular pressure higher than 21 mm Hg, and unremarkable computerized visual field examination results. Patients underwent up to three VEP measurements with blue-on-yellow pattern stimulation, as well as qualitative and morphometric evaluation of color stereo optic disc photographs. Mean follow-up time between measurements was 24 months. VEP measurements were separately analyzed in preperimetric subjects, with and without progression of optic nerve damage. Progression of glaucoma was defined as increasing loss of neuroretinal rim. RESULTS A separate analysis of VEP peak times in patients in the preperimetric group, with and without progression of glaucomatous optic nerve damage, showed no significant difference at baseline but a significant prolongation (P = 0.01) in patients with progressive disease, 2 years before morphologic changes were evident. VEPs in patients with nonprogressive disease were statistically unchanged during the observation period. The perimetric group and both preperimetric groups showed significantly prolonged VEP peak times in comparison with the control group (P < 0.001). CONCLUSIONS In addition to photographic evaluation to detect glaucomatous disc atrophy, the blue-on-yellow VEP may be an objective electrophysiological tool for monitoring patients with glaucoma, because peak times are significantly associated with progression of optic nerve damage.