Electrophysiological Evidence of Early Functional Damage in Glaucoma and Ocular Hypertension
Electrophysiological Evidence of Early Functional Damage in Glaucoma and Ocular Hypertension
复制标题
DOI：
10.1167/iovs.09-3409
复制
发表时间：
2010-02-01
影响因子：
4.4
通讯作者：
Morgan, James E.
中科院分区：
文献类型：
--
作者：
North, Rachel V.;Jones, Adrian L.;Morgan, James E.
目的。高眼压和青光眼早期视网膜神经节细胞损伤的定量研究。本文对30例开角型青光眼治疗组、23例高眼压组和28例健康对照组进行了单眼视网膜电图（ERG）、L&M（长中波长）锥型ERG和S（短波长）锥型ERG的测定。青光眼的诊断是基于三位青光眼专家对数字立体视神经头图像的模糊评估。采用扫描激光检眼镜和光学相干断层扫描对视神经头和视网膜神经纤维层进行评估。与对照组相比，高眼压组和开角型青光眼组各类型ERG的平均振幅均降低。在高眼压组中，N95和lm通路的光性负反应（PhNR）明显减弱（与对照组相比分别减弱19%和18%；开角型青光眼组与对照组相比分别减弱30%和22%）。在开角型青光眼患者中，ERG P50-N95模式是最敏感的电生理指标，而扫描激光眼底镜检查杯盘面积比是最敏感的成像参数。成像和电生理参数之间存在适度但无统计学意义的相关性。椎间盘外观用于开角型青光眼和高眼压的分类，在这两种情况下均发现明显的电生理损失。结构和电生理测量之间的适度相关性表明，它们评估病理过程的不同方面；电生理学可以用来量化视网膜神经节细胞功能障碍发生在细胞死亡之前。（中国眼科杂志，2010;51:1216-1222）DOI: 10.1167/iovs.09-3409
PURPOSE. The quantification of early retinal ganglion cell damage in ocular hypertension and glaucoma.METHODS. Thirty subjects under treatment for open-angle glaucoma, 23 subjects with ocular hypertension, and 28 healthy subjects in a control group were investigated by monocular pattern electroretinogram (ERG), L&M (long and medium wavelength) cone ERG, and S (short wavelength)-cone ERG. The diagnosis of glaucoma was based on masked assessment of digital stereoscopic optic nerve head images by three glaucoma specialists. The optic nerve head and retinal nerve fiber layer was assessed by scanning laser ophthalmoscopy and optical coherence tomography.RESULTS. All types of ERG had reduced mean amplitudes in ocular hypertension and open-angle glaucoma groups compared with the control group. In the ocular hypertension group, the N95 and the L&M-pathway photopic negative response (PhNR) were significantly attenuated (by 19% and 18% compared with the control group, respectively; by 30% and 22%, respectively, in the open-angle glaucoma group compared with the control group). In the subjects with open-angle glaucoma, the pattern ERG P50-N95 was found to be the most sensitive electrophysiological test, and the cup-disc area ratio, when examined by scanning laser ophthalmoscopy, was the most sensitive imaging parameter. Modest but not statistically significant correlations were found between the imaging and electrophysiologic parameters.CONCLUSIONS. With disc appearance used for the classification of open-angle glaucoma and ocular hypertension, significant electrophysiological losses were found in both conditions. The modest correlation between the structural and electrophysiological measures suggests that these assess different aspects of the pathologic process; electrophysiology can be used to quantify retinal ganglion cell dysfunction that occurs before cell death. (Invest Ophthalmol Vis Sci. 2010; 51: 1216-1222) DOI: 10.1167/iovs.09-3409