Evaluation of a two-stage neural model of glaucomatous defect: an approach to reduce test-retest variability.
Evaluation of a two-stage neural model of glaucomatous defect: an approach to reduce test-retest variability.
复制标题
青光眼缺陷两阶段神经模型的评估：减少重测变异性的方法。
DOI：
10.1097/01.opx.0000225091.60457.f4
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Dul,MitchellW
中科院分区：
文献类型：
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作者：
Pan,Fei;Swanson,WilliamH;Dul,MitchellW
目的：本研究的目的是建立周边缺陷和变异性的模型，并确定刺激条件，可以减少变异性，同时保持良好的能力，以检测神经性昏迷defects.Methods。Swanson等人的两阶段神经模型。1扩展，以探讨周边缺陷，反应变异性和异质性神经性昏迷神经节细胞损伤之间的关系。通过使用直径为0.43的标准亮度增量和两种创新刺激来测试青光眼患者来评估模型的预测，所述两种创新刺激旨在利用调谐到低空间频率的皮质机制。创新的刺激是一个亮度调制的Gabor刺激（0.5 C/deg）和圆形等亮度的红色-绿色的彩色刺激，其大小接近正常的Ricco的领域的彩色机制。17名青光眼患者在2周内分别接受了两次测试。在根据视网膜神经纤维束模式选择的偏心率从10到21的八个位置处测量敏感性。缺陷深度和响应（重测）的变异性进行了比较创新的刺激和标准stimulation.Results.The模型预测，在有缺陷的地区的响应变异性将低于我们的创新刺激比传统的周边刺激具有类似的缺陷深度，如果检测的彩色和Gabor刺激是由空间机制调节到低空间频率。实验数据与这些预测一致。所有三种刺激的缺损深度相似（F= 1.67，p> 0.19）。彩色刺激的平均反应变异性低于其他刺激（F= 5.58，p< 0.005），并且在具有更严重缺陷的区域中，伽柏刺激的平均反应变异性低于标准刺激（t= 2.68，p< 0.005）。变异性增加的缺陷深度的标准和Gabor刺激（p< 0.005），但不是彩色刺激（斜率小于zero.Conclusions），使用大周长刺激检测皮质机制调谐到低空间频率可以降低反应的变异性，而不包括检测昏迷性缺陷的能力。
Purpose.The purpose of this study is to model perimetric defect and variability and identify stimulus conditions that can reduce variability while retaining good ability to detect glaucomatous defects.Methods.The two-stage neural model of Swanson et al. 1 was extended to explore relations among perimetric defect, response variability, and heterogeneous glaucomatous ganglion cell damage. Predictions of the model were evaluated by testing patients with glaucoma using a standard luminance increment 0.43 in diameter and two innovative stimuli designed to tap cortical mechanisms tuned to low spatial frequencies. The innovative stimuli were a luminance-modulated Gabor stimulus (0.5 c/deg) and circular equiluminant red–green chromatic stimuli whose sizes were close to normal Ricco's areas for the chromatic mechanism. Seventeen patients with glaucoma were each tested twice within a 2-week period. Sensitivities were measured at eight locations at eccentricities from 10 to 21 selected in terms of the retinal nerve fiber bundle patterns. Defect depth and response (test–retest) variability were compared for the innovative stimuli and the standard stimulus.Results.The model predicted that response variability in defective areas would be lower for our innovative stimuli than for the conventional perimetric stimulus with similar defect depths if detection of the chromatic and Gabor stimuli was mediated by spatial mechanisms tuned to low spatial frequencies. Experimental data were consistent with these predictions. Depth of defect was similar for all three stimuli (F= 1.67, p> 0.19). Mean response variability was lower for the chromatic stimulus than for the other stimuli (F= 5.58, p< 0.005) and was lower for the Gabor stimulus than for the standard stimulus in areas with more severe defects (t= 2.68, p< 0.005). Variability increased with defect depth for the standard and Gabor stimuli (p< 0.005) but not for the chromatic stimulus (slope less than zero).Conclusions.Use of large perimetric stimuli detected by cortical mechanisms tuned to low spatial frequencies can make it possible to lower response variability without comprising the ability to detect glaucomatous defect.