Phosphene Thresholds Elicited by Transcorneal Electrical Stimulation in Healthy Subjects and Patients with Retinal Diseases
Phosphene Thresholds Elicited by Transcorneal Electrical Stimulation in Healthy Subjects and Patients with Retinal Diseases
复制标题
DOI：
10.1167/iovs.12-9612
复制
发表时间：
2012-11-01
影响因子：
4.4
通讯作者：
Gekeler, Florian
中科院分区：
文献类型：
--
作者：
Naycheva, Lubka;Schatz, Andreas;Gekeler, Florian
目的.评估健康受试者和视网膜疾病患者的电诱发光幻视阈值（EPT），并评估其可重复性和与常见眼科检查的可能相关性。共有117名受试者参与研究：健康受试者（n = 20）和视网膜色素变性（RP，n = 30）、Stargardt病（STG，n = 14）、视网膜动脉阻塞（RAO，n = 20）、非动脉炎性前部缺血性视神经病变（NAION，n = 16）和原发性开角型青光眼（POAG，n = 17）患者。使用DTL电极在3、6、9、20、40、60和80 Hz下用5 + 5 ms双相电流脉冲测定EPT。受试者接受两次检查（重测范围：1 - 6周）。建立了描述EPT电流-频率关系的经验模型。评估视力、视野（动态+静态）、电生理（RP、RAO、STG：视网膜电图[ERG]/多焦ERG; POAG：模式ERG; NAION：VEP）、裂隙灯生物显微镜检查、眼底检查和眼压测量。EPT在疾病组之间存在差异（20 Hz：健康受试者：0.062 +/-0.038 mA; STG：0.102 +/-0.097 mA; POAG：0.127 +/-0.09 mA; NAION：0.244 +/-0.126 mA; RP：0.371 +/-0.223 mA; RAO：0.988 +/-1.142 mA）。在所有组中，EPT在20 Hz时最低。在视网膜疾病患者中，除了20 Hz（P = 0.09）和40 Hz（P = 0.17）的STG外，所有频率的EPT均显著高于健康受试者。在20 Hz时，健康组和疾病组的重测差异分别为0.006 mA和0.003 - 0.04 mA。考虑到EPT检测的快速、安全和可靠的实用性，该检测可能会在临床环境中更经常地使用。EPT的测定可能有助于阐明眼科疾病的进展，无论是在标准临床评估之外，还是在这些标准测试不能有意义地使用的条件下。（ClinicalTrials.gov编号，NCT 00804102。）（Invest Ophthalmol维斯科学。2012; 53：7440 - 7448）DOI：10.1167/iovs.12 - 9612
PURPOSE. To evaluate electrically evoked phosphene thresholds (EPTs) in healthy subjects and in patients with retinal disease and to assess repeatability and possible correlations with common ophthalmologic tests.METHODS. In all, 117 individuals participated: healthy subjects (n = 20) and patients with retinitis pigmentosa (RP, n = 30), Stargardt's disease (STG, n = 14), retinal artery occlusion (RAO, n = 20), nonarteritic anterior ischemic optic neuropathy (NAION, n = 16), and primary open-angle glaucoma (POAG, n = 17). EPTs were determined at 3, 6, 9, 20, 40, 60, and 80 Hz with 5+5-ms biphasic current pulses using DTL electrodes. Subjects were examined twice (test-retest range: 1-6 weeks). An empirical model was developed to describe the current-frequency relationship of EPTs. Visual acuity, visual field (kinetic + static), electrophysiology (RP, RAO, STG: Ganzfeld-electroretinography [ERG]/multifocal-ERG; POAG: pattern-ERG; NAION: VEP), slit-lamp biomicroscopy, fundus examination, and tonometry were assessed.RESULTS. EPTs varied between disease groups (20 Hz: healthy subjects: 0.062 +/- 0.038 mA; STG: 0.102 +/- 0.097 mA; POAG: 0.127 +/- 0.09 mA; NAION: 0.244 +/- 0.126 mA; RP: 0.371 +/- 0.223 mA; RAO: 0.988 +/- 1.142 mA). In all groups EPTs were lowest at 20 Hz. In patients with retinal diseases and across all frequencies EPTs were significantly higher than those in healthy subjects, except in STG at 20 Hz (P = 0.09) and 40 Hz (P = 0.17). Test-retest difference at 20 Hz was 0.006 mA in the healthy group and 0.003-0.04 mA in disease groups.CONCLUSIONS. Considering the fast, safe, and reliable practicability of EPT testing, this test might be used more often under clinical circumstances. Determination of EPTs could be potentially useful in elucidation of the progress of ophthalmologic diseases, either in addition to standard clinical assessment or under conditions in which these standard tests cannot be used meaningfully. (ClinicalTrials.gov number, NCT00804102.) (Invest Ophthalmol Vis Sci. 2012; 53: 7440-7448) DOI:10.1167/iovs.12-9612