Correlation between photopic negative response and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes
Correlation between photopic negative response and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes
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DOI：
10.1167/iovs.07-0887
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发表时间：
2008-05-01
影响因子：
4.4
通讯作者：
Kurosaka, Daijiro
中科院分区：
文献类型：
--
作者：
Machida, Shigeki;Gotoh, Yasutaka;Kurosaka, Daijiro
目的。探讨青光眼视网膜电图（ERG）的光性负反应（PhNR）与视网膜神经纤维层厚度和视盘形貌是否存在显著相关性。对53例开角型青光眼患者的99只眼和28例正常人的30只眼进行了研究。在蓝色背景（470 nm, 40 cd/m2）下，红色刺激（644 nm, 1600 cd/m(2)）可激发光性ERGs。通过静态视野分析得到了视野的平均偏差（MD）。用激光共聚焦扫描法测定视神经头的形貌。用扫描激光偏振仪测量视神经头周围视网膜神经纤维层厚度。PhNR的振幅和PhNR/b波比值随视野缺损程度的增加而减小。PhNR振幅和PhNR/b波振幅比的对数值与MD的相关性优于线性值。PhNR振幅和PhNR/b波振幅比与RNFLT、视盘边缘面积和杯盘面积比显著相关。当线性表示时，这些相关性比对数表示时更高。使用最佳截止值时，PhNR振幅的敏感性和特异性分别为77%和90%，PhNR/b波振幅比的敏感性和特异性分别为70%和87%。虽然a波振幅与MD相关，但大多数患者的a波振幅都在正常范围内。b波振幅与MD的相关性不显著。PhNR振幅与OAG眼视网膜神经元功能和形态的下降有关。PhNR与结构参数之间的线性关系表明，青光眼患者视网膜内功能随神经功能丧失而成比例下降。
PURPOSE. To investigate whether there is a significant correlation between the photopic negative response (PhNR) of the electroretinogram ( ERG) and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes.METHODS. Ninety-nine eyes of 53 patients with open-angle glaucoma (OAG) and 30 eyes of 28 normal volunteers were studied. Photopic ERGs were elicited by red stimuli ( 644 nm, 1600 cd/m(2)) on a blue background ( 470 nm, 40 cd/m2). The mean deviation ( MD) of the visual field was obtained by static visual field analyses. The topography of the optic nerve head was determined by confocal scanning laser ophthalmoscopy. The retinal nerve fiber layer thickness (RNFLT) around the optic nerve head was measured with a scanning laser polarimeter.RESULTS. The amplitude of the PhNR and the PhNR/b-wave ratio decreased with an increase in visual field defects. The logarithmic values of the PhNR amplitude and PhNR/b-wave amplitude ratio were significantly correlated with the MD better than the linear values. The PhNR amplitude and PhNR/b-wave amplitude ratio were significantly correlated with the RNFLT and the rim area of the optic disc and with the cup/disc area ratio. These correlations were higher when expressed linearly than when stated logarithmically. The sensitivity and specificity were 77% and 90% for the PhNR amplitude and 70% and 87% for the PhNR/b-wave amplitude ratio when the optimal cutoff values were used. Although the a- wave amplitude correlated with the MD, the a- wave amplitudes of most of the patients fell within the normal range. The correlation between the b-wave amplitude and MD was not significant.CONCLUSIONS. The PhNR amplitudes correlate with the decrease in function and morphology of retinal neurons in eyes with OAG. The linear relationship between the PhNR and the structural parameters indicates that inner retinal function declines proportionately with neural loss in eyes with glaucoma.