Photopic Negative Response of Focal Electoretinograms in Glaucomatous Eyes
Photopic Negative Response of Focal Electoretinograms in Glaucomatous Eyes
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DOI：
10.1167/iovs.08-1946
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发表时间：
2008-12-01
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;Toba, Yoshiharu;Kurosaka, Daijiro
目的.目的探讨局灶视网膜电图（fERG）明视负反应（PhNR）对青光眼的诊断价值。对38例开角型青光眼（OAG）患者59只眼、12例可疑青光眼患者和32例正常人32只眼进行了研究。通过在黄斑区、黄斑的上颞区和下颞区上的15个刺激点引起fERG。采用标准自动视野计（SAP）测量视觉敏感度的平均值。根据受试者工作特征曲线，获得区分昏迷眼和正常眼的最佳局灶性PhNR截止振幅和局灶性PhNR/b波振幅比值。OAG患者的PhNR波幅明显小于正常对照组（P < 0.00001）。平均灵敏度（dB，对数尺度）和PhNR振幅之间，和平均灵敏度和PhNR/b波振幅比之间的曲线关系。在将平均敏感度从对数转换为线性标度后，PhNR的振幅和PhNR/b波比率与所有视网膜区域中SAP确定的视觉敏感度呈线性相关（r = 0.428 -0.544，P < 0.0001）。当采用最佳截断值时，PhNR/b波振幅比的敏感性和特异性分别为98.3%和90.1%。局灶性PhNR振幅的降低与OAG中视网膜敏感性的局部降低相关。高灵敏度和特异性表明局灶性PhNR可用于检测OAG的功能丧失。（Invest Ophthalmol维斯科学。2008; 49：5636-5644）DOI：10.1167/iovs.081946
PURPOSE. To determine the clinical importance of the photopic negative response (PhNR) of the focal electoretinogram (fERG) for diagnosing glaucoma.METHODS. Fifty-nine eyes of 38 patients with open-angle glaucoma (OAG), 12 glaucoma suspects, and 32 eyes of 32 normal controls were studied. The fERGs were elicited by a 15 stimulus spot on the macula region, the supero-temporal, and infero-temporal regions of the macula. The mean of the visual sensitivity was measured by standard automated perimetry (SAP). The optimal cutoff amplitudes of the focal PhNR and ratios of the focal PhNR/b-wave amplitudes that discriminated glaucomatous eyes from normal eyes were obtained from the receiver operating characteristic curves.RESULTS. The amplitudes of the PhNR were significantly smaller in patients with OAG than in normal controls (P < 0.00001). A curvilinear relationship was found between the mean sensitivity (dB, on log scale) and the PhNR amplitude, and between the mean sensitivity and the PhNR/b-wave amplitude ratio. After converting the mean sensitivity from a logarithmic to a linear scale, the amplitude of the PhNR and PhNR/b-wave ratio were linearly correlated with the SAP-determined visual sensitivity in all retinal areas (r = .428-0.544, P < 0.0001). When the optimal cutoff values were used, the sensitivity and specificity of the PhNR/b-wave amplitude ratio were 98.3% and 90.1%, respectively.CONCLUSIONS. The reduction of the focal PhNR amplitude was associated with a local decrease in the retinal sensitivity in OAG. The high sensitivity and specificity suggest that the focal PhNR can be used to detect functional loss in OAG. (Invest Ophthalmol Vis Sci. 2008; 49: 5636-5644) DOI:10.1167/iovs.081946